Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative emesis following otoplasty in children.
Sixty unpremedicated children aged between 3 and 14 years, scheduled for otoplasty, were randomly divided into one of three groups to receive either ondansetron 0.1 mg.kg-1, droperidol 75 micrograms.kg-1, or placebo at induction of anaesthesia. All patients received a standard general anaesthetic using thiopentone, atracurium and halothane. Opioid analgesia was avoided intra-operatively and infiltration with local anaesthetic was used prior to the start of surgery. ⋯ There was no difference between the placebo or droperidol group in the incidence of vomiting or time to ingestion of oral fluids and meals. Three patients in the ondansetron group had a self-terminating nodal rhythm which was not associated with any haemodynamic disturbances. Postoperatively there were no untoward incidents in any of the groups and all patients were discharged home the day after surgery.
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Randomized Controlled Trial Clinical Trial
SCOTI--a new device for identification of tracheal intubation.
A new lightweight device for the detection of placement of a tracheal tube in the trachea or oesophagus is described. The device utilises a sonic technique detecting resonating frequencies in an open (trachea) or closed (oesophagus) structure. Evaluation of the device in a clinical environment is described and it has been shown to be capable of verifying the correct placement of the tracheal tube in the trachea in 98% of patients studied. Further evaluation of this intubating aid appears justified.
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Randomized Controlled Trial Clinical Trial
Pressure support ventilation during isoflurane anaesthesia.
We have studied the respiratory effects of 5 and 10 cmH2O pressure support ventilation during anaesthesia with 1.5% end-tidal concentration of isoflurane in nine healthy, spontaneously breathing, adult patients. Some of the patients demonstrated an irregular respiratory pattern with periods of apnoea and we therefore went on to study a further seven patients with a continuous 500 s recording of airflow. Pressure support ventilation augmented mean (SD) tidal volume from 212 (56) ml to 360 (88) ml at 5 cmH2O and to 509 (108) ml at 10 cmH2O (n = 16, p < 0.05). ⋯ Mean (SD) inspiratory work of breathing decreased from 1.77 (0.70) J. min-1 to 0.31 (0.36) J.min-1 at 5 cmH2O and 0.16 (0.26) J.min-1 at 10 cmH2O pressure support ventilation (n = 9, p < 0.05). Analysis of the respiratory rhythm in the second group of seven patients revealed an oscillating respiratory pattern in four patients at 5 cmH2O and six of the seven patients at 10 cmH2O pressure support ventilation. The metabolic advantage of the decreased work of breathing during pressure support ventilation during anaesthesia is unlikely to balance the disadvantage of an oscillating respiratory rhythm.
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Clinical Trial Controlled Clinical Trial
Gastric regurgitation during general anaesthesia in different positions with the laryngeal mask airway.
Ninety patients, divided into three groups of 30, were investigated to determine the incidence of gastric regurgitation during general anaesthesia administered via the laryngeal mask airway in the supine, Trendelenburg and lithotomy positions. Fifteen minutes before induction of anaesthesia each patient swallowed a 75 mg methylene blue capsule. At the end of surgery, the LMA and the oropharynx were inspected for bluish discoloration which was considered to be a sign of gastric regurgitation. No blue dye was detected in the supine group but it was observed in one patient in each of the other two groups.
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All patients discharged from a general intensive care unit over a 4.5 year period were sent a questionnaire 3 months after discharge which investigated aspects of their health and physical abilities. Replies were compared on the basis of age, diagnosis and sickness severity on admission. Five hundred and four questionnaires were analysed. ⋯ Patients aged 76 years or older were more likely to perceive their health as 'better than average' than younger patients (p < 0.01). Eight percent of patients would be unwilling to undergo intensive care again. An unacceptable health status after intensive care cannot be predicted in any group of patients.