British journal of anaesthesia
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Randomized Controlled Trial Multicenter Study Clinical Trial
Randomized crossover comparison of the proseal with the classic laryngeal mask airway in unparalysed anaesthetized patients.
The ProSeal is a wire-reinforced laryngeal mask airway with an additional drain tube that leads to the distal tip of the laryngeal cuff. The design should improve the seal with the larynx. ⋯ The ProSeal is more difficult to insert than the classic laryngeal mask airway but allows positive pressure ventilation more reliably than the classic laryngeal mask airway.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of mepivacaine and lidocaine for intravenous regional anaesthesia: pharmacokinetic study and clinical correlation.
Limitations to the use of lidocaine for intravenous regional anaesthesia (IVRA) include lack of optimal intraoperative analgesia and systemic toxic reactions. This randomized double-blind study was conducted to compare intraoperative and postoperative analgesia, adverse effects, and plasma concentrations of mepivacaine or lidocaine, on release of the tourniquet in patients undergoing IVRA for distal upper limb surgery. ⋯ Mepivacaine 5 mg kg(-1) ensured better intraoperative analgesia than lidocaine 3 mg kg(-1) when used for IVRA. Plasma concentrations of lidocaine decreased significantly between 5 and 60 min following tourniquet deflation, whereas blood concentrations of mepivacaine remained below the toxic concentration.
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With the increasing number of critically ill patients, and shortage of intensive care unit and ward beds, some postoperative patients stay for an unnecessarily long period in the postanaesthesia care unit (PACU), until a suitable bed is available. ⋯ Patient overflow to the PACU is a common problem that requires attention. Guidelines for medical and nursing coverage, patient triage, and communication with relatives need to be outlined.
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Randomized Controlled Trial Clinical Trial
Glucose, insulin and potassium for heart protection during cardiac surgery.
Coronary artery bypass grafting with hypothermic cardiac arrest and cardiopulmonary bypass (CPB) is associated with myocardial injury. Our study investigated whether an infusion of glucose, insulin and potassium (GIK) during elective coronary artery bypass surgery decreases myocardial cell death. ⋯ The results suggest that GIK does not decrease the irreversible myocardial damage associated with routine coronary artery bypass surgery.
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Randomized Controlled Trial Clinical Trial
Effect of perioperative administration of dexketoprofen on opioid requirements and inflammatory response following elective hip arthroplasty.
In this double-blind, randomized, placebo-controlled trial, the safety and analgesic efficacy of perioperative dexketoprofen were evaluated. ⋯ Perioperative administration of dexketoprofen 25 mg 8 hourly markedly improves analgesia and decreases opioid requirements (and associated adverse effects) following hip arthroplasty. It appears that this regimen decreases the postoperative pro-inflammatory response.