British journal of anaesthesia
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Randomized Controlled Trial
Analgesic efficacy of ultrasound-guided transversus abdominis plane block in patients undergoing open appendicectomy.
Transversus abdominis plane (TAP) block is a new regional anaesthetic technique that blocks abdominal neural afferents by introducing local anaesthetic into the neuro-fascial plane between the internal oblique and the transversus abdominis muscles. We evaluated its analgesic efficacy in patients undergoing open appendicectomy in a randomized controlled double-blinded clinical trial. ⋯ Ultrasound-guided TAP block holds considerable promise as a part of a balanced postoperative analgesic regimen for patients undergoing open appendicectomy.
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Randomized Controlled Trial
Influence of different remifentanil concentrations on the performance of the surgical stress index to detect a standardized painful stimulus during sevoflurane anaesthesia.
Although measurement of cerebral hypnotic drug effect and muscle relaxation is common clinical routine during anaesthesia, a reliable measurement of the neurophysiological effects evoked by a painful stimulus is still missing. Recently, the surgical stress index (SSI) has been introduced as a surrogate measure of 'nociception'. The present study aimed to examine the influence of increasing remifentanil concentrations on the ability of SSI to detect a standardized painful stimulus during sevoflurane anaesthesia. ⋯ The SSI response to tetanic stimulation was dependent on the remifentanil concentration.
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The safe performance of regional anaesthesia (RA) requires theoretical knowledge and good manual skills. Virtual reality (VR)-based simulators may offer trainees a safe environment to learn and practice different techniques. However, currently available VR simulators do not consider individual anatomy, which limits their use for realistic training. We have developed a VR-based simulator that can be used for individual anatomy and for different anatomical regions. ⋯ Subject-specific training of RA is supported in a virtual environment. We have adapted segmentation algorithms and developed a VR-based simulator for the inguinal region for use in training for different peripheral nerve blocks. In contrast to available VR-based simulators, our simulation offers anatomical variety.