British journal of anaesthesia
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Randomized Controlled Trial
Long-term quality of sleep after remifentanil-based anaesthesia: a randomized controlled trial.
Clinical and pre-clinical data agree that opioids disrupt sleep architecture. Recently, remifentanil has been suggested to cause possible long-term disturbances of sleep quality. This randomized controlled clinical trial was designed to substantiate or refute a possible long-term effect of remifentanil on the quality of sleep. ⋯ The intraoperative use of remifentanil in a general patient population does not significantly alter the quality of sleep in the postoperative period. However, it may result in a significant reduction in the quality of sleep in patients before operation considered good sleepers. These changes were not observed in the group of patients receiving fentanyl. The relevance of these findings in terms of patient recovery and quality-of-life warrants further investigation. Trial Registration. ACTRN12610000362099.
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Randomized Controlled Trial
Does warm-up using mental practice improve crisis resource management performance? A simulation study.
Mental practice (MP) is defined as the 'symbolic rehearsal of a physical activity in the absence of any gross-muscular movements' and has been used in sport and music to enhance performance. In healthcare, MP has been demonstrated to improve technical skill performance of surgical residents. However, its effect on crisis resource management (CRM) skills has yet to be determined. We aimed to investigate the effect of warm-up with MP on CRM skill performance during a simulated crisis scenario. ⋯ Unlike technical skills, warm-up with MP does not seem to improve CRM skills in simulated crisis scenarios.
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Randomized Controlled Trial Comparative Study
Comparison of propofol and fentanyl administered at the end of anaesthesia for prevention of emergence agitation after sevoflurane anaesthesia in children.
Propofol 1 mg/kg reduces emergence delirium in children, without increasing nausea, vomiting or length of PACU stay, unlike fentanyl 1 mcg/kg.
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Randomized Controlled Trial Comparative Study
A double-blinded randomized evaluation of alfentanil and morphine vs fentanyl: analgesia and sleep trial (DREAMFAST).
Patients using fentanyl patient-controlled analgesia (PCA), the standard first-line choice in our hospitals, commonly complain of postoperative sleep disruption due to pain. The aim of this study was to determine whether the PCA combination of alfentanil and morphine, which provides longer analgesia without compromising onset speed, would improve postoperative pain-related sleep interference. ⋯ Despite better early postoperative analgesia, pain-related sleep interference was not improved by the PCA combination of alfentanil and morphine. AUSTRALIAN NEW ZEALAND CLINICAL TRIALS REGISTRY: Ref: ACTRN12608000118303.
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Randomized Controlled Trial Comparative Study
Ultrasound visual image-guided vs Doppler auditory-assisted radial artery cannulation in infants and small children by non-expert anaesthesiologists: a randomized prospective study.
Cannulation of the radial artery in infants and small children can be challenging, even for the most experienced providers. Utilizing Doppler to aid in radial artery cannulation has been well described. Recent studies have demonstrated the efficacy of ultrasound (US) image-guided vascular access techniques in the paediatric population. The utility of these two techniques, when used by non-expert personnel, has not been studied. ⋯ US-guided radial arterial cannulation in infants and small children provided a greater chance for success at the first attempt compared with the Doppler-assisted technique.