Der Anaesthesist
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Randomized Controlled Trial
Effect of ultrasound-guided intercostal nerve block on postoperative pain after percutaneous nephrolithotomy : Prospective randomized controlled study.
The aim of the study was to investigate the effect of preoperative ultrasound-guided (US) intercostal nerve block (ICNB) in the 11th and 12th intercostal spaces on postoperative pain control and tramadol consumption in patients undergoing percutaneous nephrolithotomy (PCNL). ⋯ In PCNL with nephrostomy tube placement US-guided ICNB performed at the 11th and 12th intercostal spaces provided effective analgesia.
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Randomized Controlled Trial
Propofol sedation in total knee replacement : effects on oxidative stress and ischemia-reperfusion damage.
This study aimed to show the effect of propofol sedation on oxidative stress and inflammation resulting from ischemia-reperfusion. ⋯ Propofol infusion in addition to spinal anesthesia may reduce oxidative damage and the inflammatory response developing due to the tourniquet in total knee replacement surgery.
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Randomized Controlled Trial Comparative Study
[Distal sciatic nerve blocks: randomized comparison of nerve stimulation and ultrasound guided intraepineural block].
The design of this study is related to an important current issue: should local anesthetics be intentionally injected into peripheral nerves? Answering this question is not possible without better knowledge regarding classical methods of nerve localization (e.g. cause of paresthesias and nerve stimulation technique). Have intraneural injections ever been avoided? This prospective, randomized comparison of distal sciatic nerve block with ultrasound guidance tested the hypothesis that intraneural injection of local anesthetics using the nerve stimulation technique is common and associated with a higher success rate. ⋯ For distal sciatic nerve blocks using the nerve stimulation technique, intraepineural injection of local anesthetics is common and associated with significant and clinically important higher success rates as well as shorter times until readiness for surgery. In both groups no block-related nerve damage was observed. The results indicate that for some blocks (e.g. sciatic, supraclavicular) perforation of the outer layers of connective tissue was always an important prerequisite for success using classical methods of nerve localization (cause of paresthesias and nerve stimulation technique). Additional nerve stimulation with an ultrasound-guided distal sciatic nerve block cannot make any additional contribution to the safety or success of the block. New insights concerning the architecture of the sciatic nerve are discussed and associated implications for the performance of distal ultrasound-guided sciatic nerve block are addressed.
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Randomized Controlled Trial Comparative Study
[Efficacy of a novel warming blanket: prospective randomized trial].
Perioperative hypothermia is a common complication of general anesthesia and occurs in up to 50 % of patients during ear, nose and throat (ENT) surgery. In this prospective, randomized controlled study the hypothesis that a new conductive warming blanket (Barrier® EasyWarm®, Mölnlycke Health Care Erkrath, Germany) is better in reducing the incidence of perioperative hypothermia in ENT surgery than insulation with a conventional hospital duvet alone was tested. ⋯ In the studied patient group the new conductive warming blanket (Barrier® EasyWarm®) showed no superiority compared to conventional thermal insulation alone.
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Randomized Controlled Trial Comparative Study
[Comparison of ready-to-use devices for emergency cricothyrotomy : randomized and controlled feasibility study on a mannequin].
According to various algorithms of airway management, emergency cricothyrotomy (coniotomy) represents the ultimate step for managing the difficult airway. As most physicians have limited experience with this technique several ready-to-use devices have emerged on the market with the aim of simplifying the procedure. However, they differ in details, such as configuration or the order of particular steps. Therefore, the intention of this randomized and controlled feasibility study was to test various sets and compare them to the classical surgical approach. ⋯ This study allowed the comparison of surgical coniotomy to several ready-to-use devices in a standardized setting utilizing a reusable plastic mannequin. The interpretation for real emergency conditions is limited as individual anatomy, traumatic alterations of the neck or complications, such as bleeding or damage of important structures were not part of the study objectives. However, all participating emergency physicians successfully used the coniotomy sets provided at the first attempt. No device required significantly more time than the surgical approach. The procedures using cuffed devices lasted longer in comparison to procedures using uncuffed ones; however, this difference would only play a minor role in reality as effective ventilation with minute volumes greater than 7 l/min will only be achieved by a cuffed cannula with a minimum internal diameter of 4 mm. Devices with no cuff or with tube diameters smaller than 4 mm will only allow oxygenation of the patient, which in turn requires an inspiratory oxygen concentration of 100% and a relatively high ventilation frequency.