British journal of anaesthesia
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Randomized Controlled Trial Comparative Study
Ultrasound reduces the minimum effective local anaesthetic volume compared with peripheral nerve stimulation for interscalene block.
Previous studies have demonstrated that lower local anaesthetic (LA) volumes can be used for ultrasound (US)-guided interscalene brachial plexus block (ISB). However, no study has examined whether US can reduce the volume required when compared with nerve stimulation (NS) for ISB. Our aim was to do this by comparing the minimum effective analgesic volumes (MEAVs). ⋯ US reduces the number of attempts, LA volume, and postoperative pain when compared with NS for ISB.
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Randomized Controlled Trial Comparative Study
Randomized controlled trial comparing morphine or clonidine with bupivacaine for caudal analgesia in children undergoing upper abdominal surgery.
Various additives have been used to increase the duration of analgesia provided by bupivacaine administered by single-shot caudal injection in children. ⋯ Caudal clonidine 2 µg kg⁻¹ in bupivacaine 0.2% provides a longer duration of analgesia and sedation compared with caudal morphine 30 µg kg⁻¹ in bupivacaine 0.2% without significant side-effects in children undergoing upper abdominal surgery.
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Comparative Study
Comparison of percutaneous electrical nerve stimulation and ultrasound imaging for nerve localization.
Percutaneous nerve stimulation (PNS) is a non-invasive technique to localize superficial nerves before performing peripheral nerve blocks, but its precision has never been evaluated by high-resolution ultrasound. This study compared stimulating points at the skin with the position of nerve structures determined by ultrasound. Correlations between distances and percutaneous stimulation thresholds were determined. ⋯ PNS with a stimulating pen is not a reliable technique for nerve localization in the brachial plexus as verified by high-resolution ultrasound.
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Randomized Controlled Trial
Dose-related attenuation of cardiovascular responses to tracheal intubation by intravenous remifentanil bolus in severe pre-eclamptic patients undergoing Caesarean delivery.
The optimal dose of remifentanil to attenuate the cardiovascular responses to tracheal intubation in pre-eclamptic patients undergoing Caesarean delivery under general anaesthesia has not been established. We compared the effects of two low doses of remifentanil on the cardiovascular responses to tracheal intubation and neonatal outcomes. ⋯ Both doses of remifentanil effectively attenuated haemodynamic responses to tracheal intubation with transient neonatal respiratory depression in pre-eclamptic patients undergoing Caesarean delivery under general anaesthesia. The 1.0 µg kg⁻¹ dose was associated with hypotension in three of 24 subjects.
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Comparative Study
Monitoring non-invasive cardiac output and stroke volume during experimental human hypovolaemia and resuscitation.
Multiple methods for non-invasive measurement of cardiac output (CO) and stroke volume (SV) exist. Their comparative capabilities are not clearly established. ⋯ LTI, EBI, and MF were able to track progressive hypovolaemia. PP decreased during hypovolaemia but its magnitude of reduction underestimated reductions in SV. PP and MF were inferior for the identification of resuscitation.