British journal of anaesthesia
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Previous studies indicate a higher incidence of awareness during anaesthesia in children than in adults, that is, around 1% vs 0.2%. In this prospective cohort study, we determined the incidence of intraoperative awareness in children undergoing elective or emergency surgery at a university children's hospital. ⋯ The incidence of awareness in this study, in children undergoing general anaesthesia, is comparable with recent reports from other countries, and appears to be higher than that reported in adults.
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Randomized Controlled Trial
Supplementary oxygen for emergency Caesarean section under regional anaesthesia.
Controversy still exists if the administration of supplementary oxygen to patients having emergency Caesarean section (CS) under regional anaesthesia is beneficial or potentially harmful. Therefore, in a prospective double-blinded study, we randomized patients having emergency CS under regional anaesthesia to receive either air or 60% oxygen until delivery and compared the effects on fetal oxygenation and lipid-peroxidation in the mother and baby. ⋯ Breathing 60% oxygen during emergency CS under regional anaesthesia increased fetal oxygenation with no associated increase in lipid-peroxidation in the mother or fetus.
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Anaphylaxis to chlorhexidine is rare. We report three cases of anaphylaxis attributed to the chlorhexidine component of Instillagel, presenting after urological surgery, while the patients were in the recovery room. ⋯ Anaphylaxis should be considered a possible diagnosis when a patient collapses in the recovery room. Investigation of suspected anaphylactic reactions related to anaesthesia is important to try and identify a likely trigger for a reaction and to help prevent further exposure and potential harm.
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Letter Case Reports
Perioperative management of a patient with maple syrup urine disease.
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Randomized Controlled Trial Multicenter Study Comparative Study
Urinary catheterization in labour with high-dose vs mobile epidural analgesia: a randomized controlled trial.
Dense perineal block from epidural analgesia increases the risk of urinary catheterization in labour. Mobile epidurals using low-dose local anaesthetic in combination with opioid preserve maternal mobility and may reduce the risk of bladder dysfunction. We conducted a three-arm randomized controlled trial to compare high-dose epidural pain relief with two mobile epidural techniques. ⋯ Relative to conventional high-dose block, mobile epidural techniques encourage the retention of normal bladder function and reduce the risk of urinary catheterization in labour.