British journal of anaesthesia
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Lidocaine with epinephrine is the most optimal solution for epidural top-up for emergency caesarean section. Adding fentanyl further speeds onset.
pearl -
Randomized Controlled Trial
Does a postoperative visit increase patient satisfaction with anaesthesia care?
Patient satisfaction with anaesthesia is unchanged by post-operative anaesthetist visit.
pearl -
Randomized Controlled Trial
Thoracic epidural analgesia or patient-controlled local analgesia for radical retropubic prostatectomy: a randomized, double-blind study.
Postoperative pain after radical retropubic prostatectomy is moderate to severe. The primary aim of this study was to assess whether intra-abdominal local anaesthetics provide similar analgesia compared with thoracic epidural analgesia (TEA). ⋯ TEA provides superior postoperative pain relief with better preservation of expiratory muscle strength compared with PCLA.
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Randomized Controlled Trial
Combined spinal and epidural anaesthesia and maternal intrapartum temperature during vaginal delivery: a randomized clinical trial.
We determined the association between combined spinal-epidural (CSE) anaesthesia and an increase in maternal intrapartum temperature and intrapartum fever. ⋯ The use of CSE is associated with a significant increase in maternal temperature and in the incidence of intrapartum maternal fever. However, the increase in maternal temperature does not appear to provoke any deleterious effects on the mother or child.
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Meta Analysis
Poor prognostic value of the modified Mallampati score: a meta-analysis involving 177 088 patients.
The modified Mallampati score is used to predict difficult tracheal intubation. We have conducted a meta-analysis of published studies to evaluate the Mallampati score as a prognostic test. A total of 55 studies involving 177 088 patients were included after comprehensive electronic and manual searches. ⋯ Meta-regression analyses did not identify any significant explanation of the heterogeneity. We conclude that the prognostic value of the modified Mallampati score was worse than that estimated by previous meta-analyses. Our assessment shows that the modified Mallampati score is inadequate as a stand-alone test of a difficult laryngoscopy or tracheal intubation, but it may well be a part of a multivariate model for the prediction of a difficult tracheal intubation.