British journal of anaesthesia
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We describe a patient at 20-22 weeks gestation, with a known difficult airway, who underwent eight sessions of electroconvulsive therapy using the ProSeal laryngeal mask airway and controlled ventilation. The airway management options for brief periods of general anaesthesia in patients with increased gastric volume are discussed.
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We report two cases who exhibited a decrease in their bispectral index (BIS) score, associated with syncope during venipuncture in patients with suspected needle phobia. In case 1, the reduction in BIS score occurred during the development of hypotension and bradycardia and may well have been caused by cerebral hypoperfusion. In case 2, the patient lost consciousness with decreasing BIS score before hypotension and bradycardia; this patient's condition could not be completely explained by cerebral hypoperfusion as a result of a vasovagal reflex because the patient's blood pressure and heart rate remained normal during the syncopal episode.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the effects of intrathecal ropivacaine, levobupivacaine, and bupivacaine for Caesarean section.
Intrathecal ropivacaine is roughly dose equivalent to bupivacaine at a ratio of 1.5:1 ropivacaine:bupivacaine.
pearl -
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Patient well-being after general anaesthesia: a prospective, randomized, controlled multi-centre trial comparing intravenous and inhalation anaesthesia.
The aim of this study was to assess postoperative patient well-being after total i.v. anaesthesia compared with inhalation anaesthesia by means of validated psychometric tests. ⋯ Total i.v. anaesthesia improves early postoperative patient well-being and reduces the incidence of PONV.
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Randomized Controlled Trial Comparative Study Clinical Trial
Optimization of desflurane administration in morbidly obese patients: a comparison with sevoflurane using an 'inhalation bolus' technique.
The concept of an 'inhalation bolus' can be used to optimize inhaled drug administration. We investigated the depth of anaesthesia, haemodynamic stability, and recovery time in morbidly obese patients resulting from bispectral index (BIS)-guided sevoflurane or desflurane administration and BIS-triggered inhalation boluses of sevoflurane or desflurane combined with titration of remifentanil. ⋯ Immediate recovery was significantly faster in the desflurane group. Overall hypnotic controllability measured by BIS was less accurate with desflurane. Overall haemodynamic controllability was better when using desflurane. Fewer episodes of hypotension were found in the desflurane group. The use of the inhalation bolus was found to be appropriate in both groups without causing severe haemodynamic side effects. Minimal BIS values were significantly lower after a desflurane bolus.