British journal of anaesthesia
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The purpose of this study was an anatomical and clinical evaluation of ultrasonography-guided rectus sheath blocks in children. ⋯ The bilateral placement of levobupivacaine 0.25% 0.1 ml kg(-1) in the space between the posterior aspect of the rectus sheath and the rectus abdominis muscle under real-time ultrasonographic guidance provides sufficient analgesia for umbilical hernia repair. The unpredictable depth of the posterior rectus sheath in children is a good argument for the use of ultrasonography in this regional anaesthetic technique in children.
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The purpose of this study was to compare neostigmine-induced reversal of vecuronium in normal weight, overweight and obese female patients. ⋯ Early reversal after neostigmine is prompt; however, recovery to a TOF ratio of 0.9 is slow in overweight and obese patients when vecuronium is dosed on the basis of the patient's RBW.
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Depth of anaesthesia monitors might help to individualize anaesthesia by permitting accurate drug administration against the measured state of arousal of the patient. In addition, the avoidance of awareness or excessive anaesthetic depth might result in improved patient outcomes. Various depth of anaesthesia monitors based on processed analysis of the EEG or mid-latency auditory-evoked potentials are commercially available as surrogate measures of anaesthetic drug effect. However, not all of them are validated to the same extent.
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Monitoring the functional and mechanical properties of the lungs during positive pressure ventilation may assist in confirming the underlying pulmonary diagnosis, allow therapeutic interventions to be accurately assessed and provide information that ensures the optimal setting of the ventilator parameters and encourages timely weaning. This article reviews the range of lung function measurements, both continuous and intermittent, that may be undertaken during mechanical ventilation. The monitoring capability of ICU ventilators is increasing in complexity.