British journal of anaesthesia
-
Randomized Controlled Trial Comparative Study
Heated lidocaine/tetracaine patch (Synera, Rapydan) compared with lidocaine/prilocaine cream (EMLA) for topical anaesthesia before vascular access.
We compared the lidocaine/tetracaine patch [Synera (USA), Rapydan (Europe)], a novel heat-aided patch using a eutectic mixture of lidocaine 70 mg and tetracaine 70 mg, with a eutectic mixture of lidocaine 25 mg ml(-1) and prilocaine 25 mg ml(-1) (EMLA Cream). The agents were administered at different time periods for local topical anaesthesia before a vascular access procedure. ⋯ The lidocaine/tetracaine patch provided effective anaesthesia with an application time as short as 10 min and was better than lidocaine/prilocaine cream at all application times shorter than 60 min, demonstrating a substantial improvement in time to onset of anaesthesia. The lidocaine/tetracaine patch provided an important alternative to lidocaine/prilocaine cream for topical local anaesthesia.
-
Randomized Controlled Trial Comparative Study
Comparative study of topical anaesthesia with lidocaine 2% vs levobupivacaine 0.75% in cataract surgery.
This study compared the efficacy of topical anaesthesia with levobupivacaine 0.75% vs lidocaine 2% during cataract surgery by phacoemulsification. ⋯ Topical anaesthesia with levobupivacaine 0.75% was more effective than lidocaine 2% in preventing pain and improving patient and surgeon comfort during cataract surgery, with similar toxicity.
-
Entropy is an anaesthetic EEG monitoring method, calculating two numerical parameters: State Entropy (SE, range 0-91) and Response Entropy (RE, range 0-100). Low Entropy numbers indicate unconsciousness. SE uses the frequency range 0.8-32 Hz, representing predominantly the EEG activity. RE is calculated at 0.8-47 Hz, consisting of both EEG and facial EMG. RE-SE difference (RE-SE) can indicate EMG, reflecting nociception. We studied RE-SE and EMG in patients anaesthetized without neuromuscular blockers. ⋯ Increased RE is followed by increased SE at nociceptive stimuli in patients not receiving neuromuscular blockers. Owing to their overlapping power spectra, the contribution of EMG and EEG cannot be accurately separated with frequency analysis in the range of 10-40 Hz.
-
Comparative Study Controlled Clinical Trial
Comparison of the i-gel with the cuffed tracheal tube during pressure-controlled ventilation.
The i-gel (Intersurgical Ltd) is a novel device that differs from other supraglottic airway devices in that it has a softer and a non-inflatable cuff. Our study was designed to assess whether the i-gel is suitable to provide pressure-controlled ventilation (PCV) during anaesthesia by measuring the gas leaks and comparing these values with that of the tracheal tube. ⋯ We suggest that the i-gel can be used as a reasonable alternative to tracheal tube during PCV with moderate airway pressures.
-
Randomized Controlled Trial
Effects of tracheal tube orientation on the success of intubation through an intubating laryngeal mask airway: study in Mallampati class 3 or 4 patients.
We evaluated the effects of conventional tracheal tube orientation on success of intubation through an intubating laryngeal mask airway (ILMA) in Mallampati class 3 or 4 patients. ⋯ Overall, tracheal intubation was successful in 91.5% of patients through an ILMA with a conventional tracheal tube in Mallampati class 3 or 4 patients. The first-attempt success rate was higher in the reverse group compared with the normal group, but the overall success rate was similar between the reverse and the normal groups.