British journal of anaesthesia
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Randomized Controlled Trial
Effect of age on the comparability of bispectral and state entropy indices during the maintenance of propofol-sufentanil anaesthesia.
Manufacturers recommend maintaining anaesthesia at a bispectral index (BIS) or state entropy (SE) index value between 40 and 60. ⋯ The agreement between BIS and SE indices is moderate and deteriorates as patients' age increases. This study cannot determine which index is best adapted for elderly patients. Additional work comparing both indices with raw EEG traces is warranted.
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Randomized Controlled Trial Comparative Study
Rapid sequence induction and intubation with rocuronium-sugammadex compared with succinylcholine: a randomized trial.
An unanticipated difficult airway may arise during rapid sequence induction and intubation (RSII). The aim of the trial was to assess how rapidly spontaneous ventilation could be re-established after RSII. We hypothesized that the time period from tracheal intubation to spontaneous ventilation would be shorter with rocuronium-sugammadex than with succinylcholine. ⋯ RSII with rocuronium followed by reversal with sugammadex allowed earlier re-establishment of spontaneous ventilation than with succinylcholine.
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Randomized Controlled Trial
Effect of different quantities of a sugared clear fluid on gastric emptying and residual volume in children: a crossover study using magnetic resonance imaging.
Gastric emptying in the first 2 h after 7 ml kg(-1) of sugared clear fluid has recently been investigated in healthy children using magnetic resonance imaging (MRI). This study aims to compare gastric volume and emptying half-life during 1 h after 3 or 7 ml kg(-1) sugared clear fluid intake. ⋯ In healthy volunteer children, residual GCV(w) 1 h after intake of 3 ml kg(-1) syrup is significantly smaller than that after 7 ml kg(-1) and within the range of baseline.
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Randomized Controlled Trial
Ultrasound assessment of cranial spread during caudal blockade in children: effect of the speed of injection of local anaesthetics.
Despite caudal blockade being the most widely used regional anaesthetic procedure for infants and children undergoing subumbilical surgery, the question whether the injection velocity of the local anaesthetic itself affects its spread in the epidural space has not yet been investigated. Thus, the aim of the present study was to measure the cranial spread of caudally administered local anaesthetics in infants and children by means of real-time ultrasonography, with a special focus on comparing the effect of using two different speeds of injection. ⋯ The main finding of the present study is that the speed of injection of the local anaesthetic does not affect its cranial spread during caudal blockade in infants and children. Therefore, the prediction of the cranial spread of the local anaesthetic, depending on the injection speed, is not possible.
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Randomized Controlled Trial
Effect of sugammadex or neostigmine neuromuscular block reversal on bispectral index monitoring of propofol/remifentanil anaesthesia.
Sugammadex is a modified γ-cyclodextrin with a novel mechanism of action for reversing the steroidal neuromuscular blocking agent rocuronium. Bispectral index (BIS) is an EEG-derived measure which can be sensitive to frontal electromyographic (EMG) artifacts. We compared BIS values before and after sugammadex or neostigmine neuromuscular block (NMB) reversal in patients with or without high EMG activity. ⋯ We have shown that reversal of NMB with sugammadex or neostigmine increased BIS values dependent on the presence of EMG activity. Thus, the effect of muscle activity reappearance during rocuronium NMB reversal spuriously increasing the BIS value should be taken into consideration when relying on BIS monitoring for evaluating propofol/remifentanil recovery.