British journal of anaesthesia
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Randomized Controlled Trial Comparative Study
Bougie-guided insertion of the ProSeal laryngeal mask airway has higher first attempt success rate than the digital technique in children.
We tested the hypothesis that bougie-guided insertion of the ProSeal laryngeal mask airway (ProSeal LMA) has higher success rate than the digital technique in children. ⋯ We conclude that bougie-guided insertion of the ProSeal LMA has a higher first attempt success rate than the digital technique in children.
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Randomized Controlled Trial
Single dose parecoxib significantly improves ventilatory function in early extubation coronary artery bypass surgery: a prospective randomized double blind placebo controlled trial.
Parecoxib, a cyclo oxygenase-2 inhibiting non-steroidal anti-inflammatory drug, has been widely used for postoperative analgesia. Our aim was to quantify the benefit of a single dose after coronary artery bypass grafting. ⋯ A single dose of parecoxib has a significant opioid sparing effect in the first 6 h after coronary artery bypass grafting which resulted in significantly improved ventilation with mild elevation of plasma creatinine within normal limits.
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At present, reversal of neuromuscular block induced by steroidal neuromuscular blocking agents (NMBAs) is achieved by administration of cholinesterase inhibitors. Chemical encapsulation of steroidal NMBAs, such as rocuronium, by a cyclodextrin is a new concept in neuromuscular block reversal. The present study evaluates the capacity of nine synthetic cyclodextrin derivatives (Org 25288, Org 25289, Org 25467, Org 25168, Org 25169, Org 25555, Org 25166, Org 26142, and Org 25969) to reverse constant neuromuscular block of approximately 90%, induced by rocuronium infusion in the Rhesus monkey, using single twitch stimulation. The ability of these cyclodextrin derivatives to reverse neuromuscular block was compared with the reversal of the same neuromuscular block by the commonly used combination of neostigmine and atropine. ⋯ Chemical encapsulation or chelation of rocuronium is a new concept in reversing neuromuscular block induced by rocuronium.
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Alveolar recruitment is one of the primary goals of respiratory care for acute lung injury. It is aimed at improving pulmonary gas exchange and, even more important, at protecting the lungs from ventilator-induced trauma. ⋯ It provides reasons for why atelectasis and atelectrauma should be avoided; it analyses current and future approaches on how to achieve and preserve alveolar recruitment; and it discusses the possibilities of detecting alveolar recruitment and derecruitment. The latter is of particular clinical relevance because interventions aimed at lung recruitment are often undertaken without simultaneous verification of their effectiveness.