British journal of anaesthesia
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Review Meta Analysis
Superficial or deep cervical plexus block for carotid endarterectomy: a systematic review of complications.
Carotid endarterectomy is commonly conducted under regional (deep, superficial, intermediate, or combined) cervical plexus block, but it is not known if complication rates differ. We conducted a systematic review of published papers to assess the complication rate associated with superficial (or intermediate) and deep (or combined deep plus superficial/intermediate). The null hypothesis was that complication rates were equal. ⋯ The conversion rate to general anaesthesia was also higher with deep/combined block (odds ratio 5.15, P < 0.0001), but there was an equivalent incidence of other systemic serious complications (odds ratio 1.13, P = 0.273; NS). We conclude that superficial/intermediate block is safer than any method that employs a deep injection. The higher rate of conversion to general anaesthesia with the deep/combined block may have been influenced by the higher incidence of direct complications, but may also suggest that the superficial/combined block provides better analgesia during surgery.
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Letter Case Reports
Antipsychotic drugs and the acute respiratory distress syndrome.
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Randomized Controlled Trial Multicenter Study Comparative Study
Single-dose aprepitant vs ondansetron for the prevention of postoperative nausea and vomiting: a randomized, double-blind phase III trial in patients undergoing open abdominal surgery.
The neurokinin(1) antagonist aprepitant is effective for prevention of chemotherapy-induced nausea and vomiting. We compared aprepitant with ondansetron for prevention of postoperative nausea and vomiting. ⋯ Aprepitant was non-inferior to ondansetron in achieving complete response for 24 h after surgery. Aprepitant was significantly more effective than ondansetron for preventing vomiting at 24 and 48 h after surgery, and in reducing nausea severity in the first 48 h after surgery. Aprepitant was generally well tolerated.
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Randomized Controlled Trial
Cricoid pressure prevents placement of the laryngeal tube and laryngeal tube-suction II.
The laryngeal tube has a potential role in patients with a difficult airway, but cricoid pressure is required if the patient is at risk of aspiration. The effect of cricoid pressure on insertion of these devices is unknown. ⋯ Continuous cricoid pressure prevents correct placement of the laryngeal tube and the laryngeal tube-suction II such that placement and ventilation via these devices are ineffective. The effect of cricoid pressure on ventilation via these devices, after correct placement, remains unknown.