British journal of anaesthesia
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Comment Letter Case Reports
Use of remifentanil in fast atrial fibrillation.
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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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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of sevoflurane/nitrous oxide versus propofol anaesthesia on somatosensory evoked potential monitoring of the spinal cord during surgery to correct scoliosis.
Use of intraoperative somatosensory evoked potential (SSEP) monitoring is helpful in spinal corrective surgery but may be affected by anaesthetic drugs. An anaesthetic technique that has less effect on SSEP or allows faster recovery is an advantage. We compared the effects on SSEP and the clinical recovery profiles of sevoflurane/nitrous oxide and propofol anaesthesia during surgery to correct scoliosis. ⋯ Sevoflurane produces a faster decrease and recovery of SSEP amplitude as well as a better conscious state on emergence than propofol.
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Randomized Controlled Trial Clinical Trial
Dexamethasone decreases the pro- to anti-inflammatory cytokine ratio during cardiac surgery.
Cytokines regulate inflammation associated with cardiopulmonary bypass (CPB). Pro-inflammatory cytokines may cause myocardial dysfunction and haemodynamic instability after CPB, but the release of anti-inflammatory cytokines is potentially protective. We studied the effects of dexamethasone on pro- and anti-inflammatory cytokine responses during coronary artery bypass grafting surgery. ⋯ Dexamethasone given before cardiac surgery changes circulating cytokines in an anti-inflammatory direction. Postoperative outcome may be improved by inhibition of the systemic inflammatory response.