Anaesthesia
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Randomized Controlled Trial Comparative Study
A randomised controlled trial of two analgesic techniques for paediatric tonsillectomy*.
Investigators from Bristol described a fentanyl- and diclofenac-based analgesic technique for tonsillectomy with low postoperative nausea and vomiting rates and low pain scores. This study compared the effectiveness of a modified Bristol technique with a codeine-based regimen with respect to PONV and analgesia. Sixty-five children, ASA 1-2, were randomly assigned to either the Bristol group (fentanyl 1-2 μg.kg(-1) and diclofenac 1-2 mg.kg(-1)) or codeine group (codeine 1.5 mg.kg(-1)). ⋯ Twenty-three per cent of children were assessed as not fit for discharge at 4 h. The codeine-based regimen may have a small advantage over the Bristol regimen, but neither technique seems ideally suited for a day-case service without a longer period of observation. You can respond to this article at http://www.anaesthesiacorrespondence.com.
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Randomized Controlled Trial
Appropriate length of epidural catheter in the epidural space for postoperative analgesia: evaluation by epidurography.
In current practice, the length of epidural catheter that should be left in the epidural space is not standardised for effective postoperative analgesia. This prospective, randomised, double-blinded study aimed to determine the most appropriate length of epidural catheter that should be inserted into the epidural space for postoperative analgesia. We recruited 102 women and assigned them into three study groups (3, 5 and 7 cm insertion). ⋯ Unilateral sensory analgesia developed in one patient in the 7 cm group and epidural catheter dislodgement was observed in four patients in the 3 cm group. In order to minimise catheter-related complications for postoperative analgesia, the most appropriate length that an epidural catheter should be left in the epidural space is 5 cm. You can respond to this article at http://www.anaesthesiacorrespondence.com.
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Comparative Study
Sonographic assessment of arterial frequency and distribution within the brachial plexus: a comparison with the cadaveric record.
We investigated the number and distribution of arteries within the brachial plexus territory using a portable ultrasound device, and compared these findings with known cadaveric data. We recruited 200 volunteers and carried out 400 brachial plexus examinations in a prospective observational study design. We identified arteries within the brachial plexus in more than 90% of subjects. ⋯ The presence of these vessels may impact upon the safety and efficacy of brachial plexus blockade. Routine pre-procedural sonographic assessment may offer improved safety and efficacy. You can respond to this article at http://www.anaesthesiacorrespondence.com.
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A simulated cardiopulmonary bypass circuit was constructed in the laboratory to compare the accuracy and precision of a new non-invasive extracorporeal oxygen saturation monitor-- the M3 monitor (Spectrum Medical LLP, Gloucester, UK) against the Siemens RAPIDLab(®) blood gas analyser (Siemens AG, Munich, Germany). Comparisons were made across a range of oxygen saturations and at different temperatures and different haemoglobin concentrations. ⋯ The mean (SD) haemoglobin concentration was 15.4 (0.6) when recorded by the M3 monitor, compared to 15.4 (0.5) g.dl(-1) measured by the blood gas analyser The M3 monitor compares favourably with the gold standard of the blood gas analyser and has the advantage of giving a continuous reading. You can respond to this article at http://www.anaesthesiacorrespondence.com.