Der Anaesthesist
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Randomized Controlled Trial Comparative Study
[Topical anesthesia before vascular access in children. Comparison of a warmth-producing lidocaine-tetracaine patch with a lidocaine-prilocaine patch].
Venepuncture is one of the most stressful situations for children during induction of general anesthesia. Therefore, many clinicians use a local anesthesia patch (EMLA) containing a mixture of lidocaine and prilocaine in order to reduce the stress for pediatric patients. This study compared the effect of a new heated topical anesthesia delivery system containing lidocaine and tetracaine (Rapydan) with the lidocaine/prilocaine patch EMLA. ⋯ After a contact time of 35 min the Rapydan patch led to superior analgesia during venous puncture than the EMLA patch. With regard to visibility of the veins and success rate of the punctures, differences between the two patches were not observed.
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Randomized Controlled Trial Comparative Study
[Quality of premedication and patient satisfaction after premedication with midazolam, clonidine or placebo : Randomized double-blind study with age-adjusted dosage].
Premedication aims at alleviating preoperative anxiety and nervousness and also at minimizing adverse effects. To our knowledge there is no study comparing efficacy and patient satisfaction of different premedications in age-adjusted dosage. ⋯ Midazolam was the most anxiolytic, sedative and favored premedication with the least adverse effects. Most patients would choose midazolam next time.
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Randomized Controlled Trial
[Management of short-term absence in a hospital : empirical investigations for implementation of an intervention protocol].
Short-term absence is an important cost factor and its impact is a challenge for all management levels. In this study the effectiveness of a supportive intervention scheme for the reduction of hospital short-term absenteeism is demonstrated. Short-term absenteeism is defined here as being away from the working place for less than 5 days. ⋯ Furthermore the effects of the intervention concept were sustained even after the formal ending of the intervention period. This activity has a significant influence on both the absenteeism statistics and the hospital's performance. An implementation of the scheme mainly in the core departments of the hospital, such as the operating theatre, anesthesiology and intensive care has proven to be very helpful.
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Randomized Controlled Trial
[EEG-adjusted target-controlled infusion : Propofol target concentration with different doses of remifentanil].
The aim of this study was to examine to what extent the use of electroencephalography (EEG) monitoring leads to an adaptation of the target-controlled infusion (TCI) concentration of propofol during propofol anaesthesia with different doses of remifentanil. ⋯ The study demonstrates that remifentanil has both analgetic and hypnotic effects. With increasing remifentanil dose the propofol requirement decreased and in this context EEG monitoring is useful to adapt the target concentrations of propofol to the patients' age and gender.
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Randomized Controlled Trial Comparative Study
[Propofol administration systems. Handling, hemodynamics and propofol consumption].
During anaesthesia propofol is administered either by manual controlled infusion (MCI) or by target controlled infusion (TCI) techniques. In this study two different TCI systems for propofol administration were evaluated with regard to handling, patient safety, and costs and compared to administration of propofol by the MCI technique. ⋯ The investigated propofol administration procedures using the MCI or TCI techniques were safe and easy to handle under BIS monitoring. No differences were found concerning extubation times and time of awaking. During extended anaesthesia procedures (>60 min), propofol consumption was lower with both TCI techniques and thus costs could be saved.