Anaesthesia
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Review Meta Analysis Comparative Study
Pentax Airway Scope(®) vs Macintosh laryngoscope for tracheal intubation in adult patients: a systematic review and meta-analysis.
Despite increasing the likelihood of a Cormack-Lehane grade 1 view, pooled results from the studies showed no difference between the Pentax Airway Scope and standard Macintosh laryngoscope for:
- Rate of intubation on first attempt.
- Time for intubation.
- Incidence of oral or pharyngeal injury.
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Randomized Controlled Trial Comparative Study
A randomised controlled trial comparing incentive spirometry with the Acapella(®) device for physiotherapy after thoracoscopic lung resection surgery.
Lung resection surgery has been associated with numerous postoperative complications. Seventy-eight patients scheduled for elective video-assisted thoracoscopic lung resection were randomly assigned to receive standard postoperative care with incentive spirometry or standard care plus positive vibratory expiratory pressure treatment using the Acapella(®) device. ⋯ In addition, 37/39 patients (95%) stated a clear preference for the Acapella device. Postoperative treatment with the Acapella device did not improve pulmonary function after thoracoscopic lung resection surgery compared with incentive spirometry, but it may be more comfortable to use.
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Randomized Controlled Trial
Bacterial contamination of surgical scrub suits worn outside the operating theatre: a randomised crossover study.
In this study, we aimed to evaluate the bacterial contamination of surgical scrub suits worn outside the operating theatre. We randomised 16 anaesthetists on separate occasions into one of 3 groups: restricted to the operating theatre only; theatre and surgical wards; and theatre and departmental office. ⋯ The mean (SD) bacterial counts, expressed as colony-forming units per cm(2) at 16:00 on the day of study, were 25.2 (43.5) for those restricted to theatre and 18.5 (25.9) and 17.9 (31.0) for those allowed out to visit the ward and office, respectively (p = 0.370). We conclude that visits to ward and office did not significantly increase bacterial contamination of scrub suits.
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Randomized Controlled Trial
The effect of pre-treatment with transcutaneous electrical acupoint stimulation on the quality of recovery after ambulatory breast surgery: a prospective, randomised controlled trial.
Electroacupuncture has been demonstrated to be effective at alleviating pain and postoperative side-effects. Our aim was to investigate whether transcutaneous electric acupoint stimulation, a low-skill alternative to needle-based electroacupuncture, could improve the quality of recovery after ambulatory surgery. Seventy-two women scheduled for cosmetic breast surgery were randomly allocated to transcutaneous electric acupoint stimulation or sham groups. ⋯ We found significant mean (SD) differences between the transcutaneous electric acupoint stimulation and sham groups in the mean (SD) length of recovery room stay (35.6 (12.9) min vs 48.3 (16.3) min, p = 0.01), time to removal of the laryngeal mask airway (10.2 (2.5) min vs 17.8 (4.4) min, p = 0.01), and time to reorientation of the patient (14.6 (3.2) min vs 26.5 (5.0) min, p = 0.01). Further, postoperative pain scores and the incidence of side-effects were all lower in the transcutaneous electric acupoint stimulation group. In conclusion, transcutaneous electric acupoint stimulation can significantly improve the quality of recovery and decrease the incidence of anaesthesia-related side-effects for patients undergoing ambulatory surgery.
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Although the brain is the target organ of general anaesthesia, the utility of intra-operative brain monitoring remains controversial. Ideally, the incorporation of brain monitoring into routine practice would promote the maintenance of an optimal depth of anaesthesia, with an ultimate goal of avoiding the negative outcomes that have been associated with inadequate or excessive anaesthesia. ⋯ Whether such devices prove to be useful will depend not only on their ability to influence anaesthetic management but also on whether the changes they promote can actually affect clinically important outcomes. This review highlights the evidence for the role of bispectral index monitoring, in particular, in guiding anaesthetic management and influencing clinical outcomes, specifically intra-operative awareness, measures of early recovery, mortality and neurocognitive outcomes.