British journal of anaesthesia
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Randomized Controlled Trial Comparative Study
Comparison of three different epidural solutions in off-pump cardiac surgery: pilot study.
Immediate extubation using thoracic epidural analgesia (TEA) has become more popular after off-pump coronary artery bypass grafting (OPCAB). In this randomized prospective double-blind study, we present the first comparison of preoperative and postoperative haemodynamics during different regimens of TEA for immediate extubation after cardiac surgery. ⋯ We conclude that immediate extubation after OPCAB using TEA is feasible with different TEA regimens. Respiratory function, haemodynamic stability and pain control are not different between TEA with bupivacaine alone, bupivacaine with fentanyl or bupivacaine with clonidine.
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Comparative Study
Performance of entropy and Bispectral Index as measures of anaesthesia effect in children of different ages.
Entropy and Bispectral Index (BIS) have been promoted as EEG-based anaesthesia depth monitors. The EEG changes with brain maturation, but there are limited published data describing the characteristics of entropy in children, and some data suggest that BIS is less reliable in young children. The aim of this study was to compare the performance of entropy as a measure of anaesthetic effect in different age groups. The performance of entropy was compared with BIS. ⋯ For both entropy and BIS the measure of anaesthetic effect was significantly different for children aged <1 yr compared with older children. There was no difference in performance of entropy and BIS. Both should be used cautiously in small children.
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Randomized Controlled Trial
Pre-oxygenation in the obese patient: effects of position on tolerance to apnoea.
In obese patients, reduced functional residual capacity exacerbated by supine position might decrease the effectiveness of pre-oxygenation and the tolerance to apnoea. The aim of this study was to compare the effect of body posture during pre-oxygenation, sitting or supine, on its effectiveness in obese patients. ⋯ Pre-oxygenation in sitting position significantly extends the tolerance to apnoea in obese patients when compared with the supine position.