British journal of anaesthesia
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We describe four cases of lost guide wires during central venous catheterization. Although percutaneous catheterization of central veins is a routine technique, it is a procedure requiring advanced operating skills, expert supervision, and attention to detail in order to prevent adverse effects.
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Randomized Controlled Trial Clinical Trial
Double-blind, placebo-controlled analgesic study of ibuprofen or rofecoxib in combination with paracetamol for tonsillectomy in children.
The analgesics used for paediatric tonsillectomy may be associated with side-effects such as sedation, respiratory depression and vomiting (opioids) or increased bleeding [non-steroidal anti-inflammatory drugs (NSAIDs)]. In our institution, we employ a combination of paracetamol, NSAID and opioid, although there is no published evidence of analgesic benefit from adding NSAIDs to paracetamol in children. ⋯ This study provides evidence to support the combination of ibuprofen (but not rofecoxib) with paracetamol for perioperative analgesia in children.
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We quantified the predictive performance of our computer model of the administration of inhalation anaesthesia from a Datex-Ohmeda Modulus CD circle-absorber system. ⋯ Administration of inhalation anaesthesia can be based on version 2 of this model, but must be guided by active monitoring.
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Systemic venous air embolism is a serious complication in patients with chronic liver disease having liver surgery. Intrapulmonary arteriovenous shunting can permit air emboli to pass into the systemic circulation. We describe a case of paradoxical air embolism detected by transoesophageal echocardiography in a patient with cirrhosis who was having a hepatic resection.
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Case Reports
Recurrent neurological symptoms in a patient following repeat combined spinal and epidural anaesthesia.
A healthy woman developed neurological symptoms after two consecutive Caesarean sections under combined spinal and epidural anaesthesia. Amethocaine was used for spinal anaesthesia and mepivacaine for epidural anaesthesia on both occasions, and a combination of fentanyl and bupivacaine was continuously infused for pain relief after the second. Her symptoms on both occasions were similar, including pain in the buttocks of 7-11 days duration and numbness in the sacral area of 5-6 months.