British journal of anaesthesia
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Randomized Controlled Trial
Influence of shoulder position on central venous catheter tip location during infraclavicular subclavian approach.
Infraclavicular approach of the subclavian veins is commonly used for central venous access. However, aberrant catheter tip locations are frequently quoted for this approach. It was hypothesized that with the shoulder pulled downwards, the angle between the internal jugular and subclavian veins may increase, directing subclavian catheters into the internal jugular vein. This prospective study assessed the influence of the shoulder position on proper placement of right infraclavicular subclavian catheters. ⋯ The neutral shoulder position minimizes the number of needle passes and the incidence of catheter misplacement during the infraclavicular approach of the right subclavian vein catheterization.
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Randomized Controlled Trial Comparative Study
Comparison between ultrasound-guided transversus abdominis plane and conventional ilioinguinal/iliohypogastric nerve blocks for day-case open inguinal hernia repair.
Transversus abdominis plane (TAP) block has been reported to provide effective analgesia after lower abdominal surgery, but there are few data comparing ilioinguinal/iliohypogastric nerve (IHN) block with ultrasound-guided TAP block in patients undergoing inguinal hernia repair. ⋯ Ultrasound-guided TAP block provided better pain control than 'blind' IHN block after inguinal hernia repair but did not prevent the occurrence of chronic pain.
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Randomized Controlled Trial
Differential effects of lidocaine and remifentanil on response to the tracheal tube during emergence from general anaesthesia.
I.V. lidocaine administration and target-controlled infusion (TCI) of remifentanil may each be used to reduce cough and haemodynamic stimulation during emergence from general anaesthesia. We therefore compared the effects of these two treatments on patients' responses to the tracheal tube during recovery from general anaesthesia after thyroid surgery. ⋯ TCI of remifentanil reduces responsiveness to the tracheal tube during emergence from general anaesthesia more effectively than does i.v. lidocaine in female patients undergoing thyroid surgery.
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Controlled Clinical Trial
Information gain in patients using a multimedia website with tailored information on anaesthesia.
The preoperative visit is an appropriate time to educate the patient on anaesthesia. The aim of this study was to determine if a website, as an information source for anaesthesia before the visit to the preoperative assessment clinic (PAC), increases patients' knowledge on anaesthesia. ⋯ A patient-tailored multimedia website is an effective way to support the information provided by the anaesthesiologist in order to inform patients about their upcoming anaesthetic procedure. The use of such a website gives a significant increase in knowledge compared with only spoken information, or spoken information combined with a brochure.
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The functional haemodynamic variables pulse pressure variation (PPV), stroke volume variation (SVV), and systolic pressure variation (SPV) are widely used to assess haemodynamic status. However, it is not known how these perform during acute lung injury (ALI). This study evaluated the effects of different ventilatory strategies on haemodynamic parameters in pigs with ALI during normovolaemia and hypovolaemia. ⋯ VT is the ventilatory parameter which influences functional haemodynamics the most. During ventilation with low VT and high PEEP, most functional variables are less able to accurately predict hypovolaemia secondary to haemorrhage, with the exception of PPV.