British journal of anaesthesia
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We used the Delphi technique to gain a consensus from 26 consultant anaesthetists about technical tasks during general anaesthesia. We then developed a technical scoring system to assess anaesthetists undertaking general anaesthesia with rapid sequence induction. ⋯ These findings suggest that simulation can be used to observe and quantify technical performance.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of remifentanil and alfentanil on the cardiovascular responses to induction of anaesthesia and tracheal intubation in the elderly.
We compared the effects of remifentanil and alfentanil on arterial pressure and heart rate at induction of anaesthesia and tracheal intubation in 40 ASA I-III patients aged greater than 65 yr, in a randomized double-blind study. ⋯ Remifentanil and alfentanil similarly attenuate the pressor response to laryngoscopy and intubation, but the incidence of hypotension confirms that both drugs should be used with caution in elderly patients.
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Randomized Controlled Trial Clinical Trial
Addition of meperidine to bupivacaine for spinal anaesthesia for Caesarean section.
In a prospective, randomized, double-blind, placebo-controlled trial, we investigated the effect of adding meperidine 10 mg to intrathecal bupivacaine on the duration of early postoperative analgesia in 40 patients having elective Caesarean section under spinal anaesthesia. ⋯ Addition of meperidine 10 mg to intrathecal bupivacaine for Caesarean section is associated with prolonged postoperative analgesia but with greater intraoperative nausea and vomiting.
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Randomized Controlled Trial Comparative Study Clinical Trial
Remifentanil by patient-controlled analgesia compared with intramuscular meperidine for pain relief in labour.
The pharmacokinetics of remifentanil suggests that it may be suitable for analgesia during labour. ⋯ In this pilot study, remifentanil by PCA gave better pain relief to mothers in labour than intramuscular meperidine. However, remifentanil is a potent respiratory depressant and adequate continuous monitoring is necessary.
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Pre-hospital endotracheal intubation for the purpose of controlled ventilation may prevent secondary brain injury in patients with severe head injury. In view of the limited monitoring devices utilized in the pre-hospital setting, little is known about the 'quality' of controlled ventilation initiated in the pre-hospital setting. ⋯ Endotracheal intubation and controlled ventilation of the lungs initiated in the pre-hospital setting do not guarantee optimal oxygenaton and ventilation in patients with severe head injury.