British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Radial artery cannulation: topical amethocaine gel versus lidocaine infiltration.
In a prospective randomized study, we compared topical 4% amethocaine gel (Ametop) with 2% lidocaine infiltration for analgesia for radial artery cannulation. A previous study had shown topical analgesia with EMLA cream reduced pain, shortened cannulation time, and improved success rates when compared with lidocaine infiltration. ⋯ There was no significant difference between these two methods of analgesia for any measured variable.
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The ProSeal laryngeal mask airway (PLMA) is a new laryngeal mask device with a modified cuff and a drainage tube. ⋯ The PLMA is a reliable airway management device that can give an effective glottic seal in paralysed and non-paralysed patients. The device allows the easy passage of a gastric tube, causes a minimal haemodynamic response to insertion, and an acceptable incidence of sore throat.
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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
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.
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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.