British journal of anaesthesia
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Randomized Controlled Trial Comparative Study
Expected difficult tracheal intubation: a prospective comparison of direct laryngoscopy and video laryngoscopy in 200 patients.
The Berci-Kaplan video laryngoscope was developed to improve the visualization of the glottis and ease tracheal intubation. Whether this technique is also effective in patients with an expected difficult intubation is unclear. We have prospectively evaluated the conditions and success rate of tracheal intubation in patients with a Mallampati score of III or IV. ⋯ Video laryngoscopy, when compared with direct laryngoscopy for difficult intubations, provides a significantly better view of the cords, a higher success rate, faster intubations, and less need for optimizing manoeuvres. Therefore, we feel that the video laryngoscopy leads to a clinically relevant improvement of intubation conditions and can be recommended for difficult airway management.
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The most common misplacement during subclavian vein (SCV) catheterization is into the ipsilateral internal jugular vein (IJV). Chest radiography is the gold standard for the confirmation of correct placement. However, it is time-consuming and has the disadvantage of radiation exposure. We assessed the sensitivity and specificity of our previously reported 'flush test' for confirming correct central line placement. ⋯ Saline flush test is a simple and sensitive bedside test that successfully detects misplaced SCV catheters into ipsilateral IJV.
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Multicenter Study Comparative Study
Comparison of two versions of the Vigileo-FloTrac system (1.03 and 1.07) for stroke volume estimation: a multicentre, blinded comparison with oesophageal Doppler measurements.
Our aim was to evaluate the validity of stroke volume measurements obtained using the Vigileo-FloTrac system in comparison with those obtained using oesophageal Doppler considered as a reference. ⋯ The precision of stroke volume estimation using Vigileo-FloTrac has improved with the second version of the software (1.07), but remains insufficient to allow the replacement of the reference technique in the population studied.
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Comparative Study Controlled Clinical Trial
Determination of the EC50 of levobupivacaine for femoral and sciatic perineural infusion after total knee arthroplasty.
Infusion of local anaesthetic through femoral and sciatic catheters is an accepted method of providing pain relief after knee arthroplasty. However, the minimum effective concentration of perineural local anaesthetics is not known. ⋯ The EC(50) for femoral perineural infusion is greater than the EC(50) for sciatic perineural infusion.
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The objective of the present study was to investigate sublingual microvascular blood flow and microcirculatory haemoglobin oxygen saturation (Smc(O(2))) during cardiopulmonary bypass (CPB) using constant systemic blood flow but different perfusion pressures achieved by phenylephrine administration. ⋯ Our data demonstrate that an increased perfusion pressure produced by phenylephrine at constant CPB flow may decrease microcirculatory blood flow in the sublingual mucosal microcirculation due to microvascular blood flow shunting.