British journal of anaesthesia
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Randomized Controlled Trial Multicenter Study
Morphine pharmacokinetics and pharmacodynamics in preterm and term neonates: secondary results from the NEOPAIN trial.
Relationships between plasma morphine concentrations and neonatal responses to endotracheal tube (ETT) suctioning are unknown in preterm neonates. ⋯ A sigmoid curve describing maturation of morphine clearance is moved to the right in preterm neonates and volume of distribution is increased compared with term neonates. Morphine does not alter the neonatal response to ETT suctioning.
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Randomized Controlled Trial Comparative Study
Spinal anaesthesia for elective surgery: a comparison of hyperbaric solutions of racemic bupivacaine, levobupivacaine, and ropivacaine.
The aim of this study was to compare the clinical effects of 'hyperbaric' bupivacaine for spinal anaesthesia with those of similar preparations of levobupivacaine and ropivacaine. ⋯ 'Hyperbaric' ropivacaine provides reliable spinal anaesthesia of shorter duration than bupivacaine or levobupivacaine, both of which are clinically indistinguishable. The recovery profile of ropivacaine may be useful where prompt mobilization is required.
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Randomized Controlled Trial Comparative Study
Effect of propofol and sevoflurane on coughing in smokers and non-smokers awakening from general anaesthesia at the end of a cervical spine surgery.
Coughing during emergence from general anaesthesia may be detrimental, particularly after cervical spine surgery. We compared the effect of propofol or sevoflurane anaesthesia on the incidence and severity of coughing during recovery in patients undergoing cervical spine surgery via an anterior approach. As a secondary aim, we also evaluated the influences of smoking and estimated residual anaesthetic agent concentrations on coughing. ⋯ The incidence of coughing after cervical spine surgery when tracheal extubation is performed according to clinical criteria is lower after propofol anaesthesia compared with sevoflurane anaesthesia. Smokers are at increased risk of coughing, independently of the type of anaesthesia maintenance. Higher residual concentrations of anaesthetic agents decrease the probability of coughing, except for smokers anaesthetized with sevoflurane.
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Randomized Controlled Trial
Effect of prewarming on post-induction core temperature and the incidence of inadvertent perioperative hypothermia in patients undergoing general anaesthesia.
Inadvertent perioperative hypothermia (IPH) occurs in many patients because warming techniques are insufficient to counteract thermal redistribution resulting from the ablation of thermoregulatory vasoconstriction associated with anaesthesia. We tested the efficiency of a preoperative forced-air warming (FAW) device (Bair Paws) in preventing IPH. ⋯ Preoperative warming using the Bair Paws system results in smaller decreases in core temperature intraoperatively and less IPH in patients undergoing spinal surgery under general anaesthesia.
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We present nine cases of one-lung anaesthesia in small children and infants in which a novel technique was used to reduce the risk of endobronchial blocker retrograde dislodgement. The technique involved threading the stem of the blocker through the Murphy eye of the endotracheal tube (ETT) and deliberately passing the tip of the ETT all the way to the carina. The tip of the ETT blocked any retrograde movement of the blocker.