British journal of anaesthesia
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Anaphylaxis during anaesthesia is a rare event that in ∼60-70% of cases is secondary to neuromuscular blocking agents. It has been suggested previously that the recent introduction of sugammadex may provide a novel therapeutic approach to the management of rocuronium-induced anaphylaxis. ⋯ This was associated with an improvement in the adverse haemodynamic state. The underlying reasons for this are unclear, but sugammadex may potentially be a useful adjunct in the management of rocuronium-induced anaphylaxis.
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Randomized Controlled Trial Comparative Study
Spinal anaesthesia for ambulatory arthroscopic surgery of the knee: a comparison of low-dose prilocaine and fentanyl with bupivacaine and fentanyl.
Prospective data on the use of prilocaine for ambulatory spinal anaesthesia remain limited. We compared the behaviour and characteristics of subarachnoid block using prilocaine and fentanyl with that of bupivacaine and fentanyl. ⋯ The combination of prilocaine and fentanyl is a better alternative to that of low-dose bupivacaine and fentanyl, for spinal anaesthesia in ambulatory arthroscopic knee surgery.
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Randomized Controlled Trial
ED₅₀ and ED₉₅ of intrathecal levobupivacaine with opioids for Caesarean delivery.
This prospective randomized double-blind dose-response study aimed to determine the ED₅₀ and ED₉₅ of intrathecal levobupivacaine combined with morphine and sufentanil for elective Caesarean delivery. ⋯ When combined with intrathecal sufentanil 2.5 µg and intrathecal morphine 100 µg, the ED₉₅ of intrathecal levobupivacaine is 12.9 mg for Caesarean delivery. If doses of levobupivacaine less than the ED₉₅, particularly near the ED₅₀, are used, these doses should be administered under a CSE technique.
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Randomized Controlled Trial
Intubating conditions and adverse events during sevoflurane induction in infants.
The aim of this study was to compare intubating conditions and adverse events after sevoflurane induction in infants, with or without the use of rocuronium or alfentanil. ⋯ In 1- to 24-month-old infants, the addition of 0.3 mg kg⁻¹ rocuronium to 8% sevoflurane improved intubating conditions and decreased the frequency of respiratory adverse events. Alfentanil provided no additional benefit in this study.
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Randomized Controlled Trial
Effect of high-dose preoperative methylprednisolone on pain and recovery after total knee arthroplasty: a randomized, placebo-controlled trial.
Total knee arthroplasty (TKA) is associated with severe pain and inflammation despite an extensive multimodal analgesic approach, but the effect of high-dose glucocorticoid administration has not been studied. ⋯ MP 125 mg before surgery improves analgesia and immediate recovery after TKA, even when combined with a multimodal analgesic regime. These findings call for further studies on safety aspects.