Anaesthesia
-
We describe the case of a 25-year-old woman presented for elective lumbar decompression and microdiscectomy who, towards the end of her surgery, developed clinical signs of anaphylaxis. Skin testing later confirmed sensitisation to levobupivacaine and possibly MediShield, an anti-adhesion gel used following microdiscectomy. ⋯ It also highlights the possibility that multiple agents may simultaneously trigger a life-threatening reaction. Anaesthetists should remain alert to the use of potentially allergenic agents employed by surgeons.
-
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.
-
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.