British journal of anaesthesia
-
Randomized Controlled Trial Multicenter Study
Iontophoretic transdermal system using fentanyl compared with patient-controlled intravenous analgesia using morphine for postoperative pain management.
The fentanyl iontophoretic transdermal system (fentanyl ITS) enables needle-free, patient-controlled analgesia for postoperative pain management. This study compared the efficacy, safety, and ease of care of fentanyl ITS with patient-controlled, i.v. analgesia (PCIA) with morphine for postoperative pain management. ⋯ Fentanyl ITS and morphine PCIA were comparably effective and safe.
-
Randomized Controlled Trial Comparative Study
Ultrasonographic guidance for sciatic and femoral nerve blocks in children.
Recent studies have shown that ultrasound guidance for paediatric regional anaesthesia can improve the quality of upper extremity and neuraxial blocks. We therefore investigated whether ultrasound guidance for sciatic and femoral nerve blocks prolongs sensory blockade in comparison with nerve stimulator guidance in children. ⋯ Ultrasound guidance for sciatic and femoral nerve blocks in children increased the duration of sensory blockade in comparison with nerve stimulator guidance. Prolonged sensory blockade was achieved with smaller volumes of local anaesthetic when using ultrasound guidance.
-
Randomized Controlled Trial Comparative Study
Emergence and early cognitive function in the elderly after xenon or desflurane anaesthesia: a double-blinded randomized controlled trial.
Postoperative cognitive impairment after general anaesthesia, especially in the elderly, is a well-recognized problem. Xenon, known to be an N-methyl-d-aspartate antagonist, may be advantageous. In this study, the early cognitive function in the elderly after general anaesthesia with xenon was compared with that after desflurane. ⋯ There was no difference in the postoperative cognitive testing at 6-12 and 66-72 h. Xenon was associated in the elderly with a faster emergence from general anaesthesia than desflurane.
-
Randomized Controlled Trial
Removal of the laryngeal tube in children: anaesthetized compared with awake.
Laryngeal tube (LT) is a useful airway device in children, but there is no objective evidence that removal of LT in awake state is better than in anaesthetized state. So, we compared the incidence of respiratory adverse events after the removal of LT, either under anaesthesia or on awakening. ⋯ LT removal in anaesthetized state reduced cough, hypersalivation, and prevented tube displacement and hypoxia. Upper airway obstruction in the anaesthetized state should be predicted and managed with chin or jaw lifting.
-
Comparative Study
Multi-level approach to anaesthetic effects produced by sevoflurane or propofol in humans: 1. BIS and blink reflex.
The relative roles of forebrain and brainstem in producing adequate anaesthesia are unclear. ⋯ The blink reflex (brainstem function) is more sensitive to sevoflurane or propofol than BIS (forebrain function). Sevoflurane suppresses the blink reflex more than propofol. Different k(e0)s for blink reflex vs BIS indicate different effect sites.