British journal of anaesthesia
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Randomized Controlled Trial
Hyperbaric articaine for day-case spinal anaesthesia.
Articaine and lidocaine are clinically very similar suggesting that articaine could be suitable for day-case spinal anaesthesia. A dose-response study with articaine in ambulatory spinal anaesthesia was therefore performed. ⋯ Hyperbaric articaine 60 and 84 mg resulted in spinal anaesthesia allowing surgery of the lower extremities for about 1 h. Recovery was rapid. Use of 108 mg of articaine is not recommended because of frequent extensive cephalad spread of the block, accompanied by arterial hypotension and nausea.
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Case Reports
Supraclavicular continuous peripheral nerve block in a wounded soldier: when ultrasound is the only option.
The complex nature of combat-related injuries requires frequent operative interventions and prolonged analgesic therapy. The application of continuous peripheral nerve block (CPNB) has been an important anaesthetic tool in the management of combat soldiers wounded from the current conflicts. ⋯ The use of ultrasound technology has improved our success in placing CPNB in the presence of such injuries. We report the application of ultrasound technology in placing CPNB in a combat-injured soldier, whose injuries precluded other CPNB options.
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The goal of the study was to compare stroke volume (SV) and respiratory stroke volume variation (SVV) measured by pulse-contour analysis and aortic Doppler. ⋯ There is a fair correlation between pulse-contour analysis and aortic Doppler for beat-by-beat measurement of SV but not for calculation of SV respiratory ventilation.
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Reversal of neuromuscular block can be accomplished by chemical encapsulation of rocuronium by sugammadex (Org 25969), a synthetic gamma-cyclodextrin derivative. The present study determined the time course of the reversal action of sugammadex on rocuronium-induced block in the anaesthetized Rhesus monkey using train-of-four stimulation. ⋯ The half-life of sugammadex (Org 25969), a new fast and efficient reversal agent for rocuronium-induced block, is relatively short in the Rhesus monkey, implying the possibility to perform neuromuscular block by rocuronium shortly after reversal of a prior block. In translation to the human situation differences in rocuronium sensitivity and kinetics should be taken into account.