British journal of anaesthesia
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Randomized Controlled Trial
Effectiveness of continuous wound infusion of 0.5% ropivacaine by On-Q pain relief system for postoperative pain management after open nephrectomy.
Block of parietal nociceptive afferent nerves using continuous wound infiltration with local anaesthetics may be beneficial in multimodal postoperative pain management. The effectiveness of continuous wound infusion of ropivacaine for postoperative pain relief after open nephrectomy was analysed in a prospective, randomized, double-blinded, placebo-controlled trial. ⋯ Continuous surgical wound infusion with ropivacaine improved pain relief and accelerated recovery and discharge reducing overall costs of care.
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Randomized Controlled Trial
Comparison of hyperbaric and plain articaine in spinal anaesthesia for open inguinal hernia repair.
Fast onset and short duration are prominent properties of the amide-type local anaesthetic articaine. Similar to bupivacaine, a hyperbaric solution of articaine may produce faster onset and shorter duration of spinal anaesthesia than a plain solution. ⋯ Hyperbaric articaine 84 mg had a faster onset and shorter duration of spinal anaesthesia than the plain solution.
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Randomized Controlled Trial
Intravenous oxytocin bolus of 2 units is superior to 5 units during elective Caesarean section.
The optimal dose of oxytocin at Caesarean section is unclear. Oxytocin may cause adverse cardiovascular effects, including tachycardia and hypotension, whereas an inadequate dose can result in increased uterine bleeding. We compared the effects of two doses of oxytocin in a randomized double-blind trial. ⋯ In elective Caesarean section, a 2 u bolus of oxytocin results in less haemodynamic change than 5 u, with less nausea and no difference in the need for additional uterotonics.
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Randomized Controlled Trial
Intraoperative thoracic epidural anaesthesia attenuates stress-induced immunosuppression in patients undergoing major abdominal surgery.
Intraoperative stress may suppress the adaptive immune system. Abolished proinflammatory lymphocyte function is associated with higher risk of infection and postoperative complications. We hypothesized that thoracic epidural anaesthesia (TEA) reduces intraoperative stress and thus attenuates lymphocyte decrease and impairment of proinflammatory lymphocyte function. ⋯ Intraoperative use of thoracic epidural catheter reduced stress response and prevented stress-induced perioperative impairment of proinflammatory lymphocyte function.
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Randomized Controlled Trial Comparative Study
Airway scope and gum elastic bougie with Macintosh laryngoscope for tracheal intubation in patients with simulated restricted neck mobility.
/st> Airway Scope is a new videolaryngoscope which requires less cervical movement during intubation than direct laryngoscopy. Thus, in patients wearing a rigid cervical collar, we compared the efficacy of the Airway Scope and the gum elastic bougie with Macintosh laryngoscope during tracheal intubation. ⋯ /st> The Airway Scope shortens intubation time, is less likely to result in oesophageal intubation, and may offer a marginally higher intubation success rate in patients with simulated restricted neck mobility.