British journal of anaesthesia
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Randomized Controlled Trial
Sphenopalatine ganglion block for the treatment of postdural puncture headache: a randomised, blinded, clinical trial.
Current treatment of postdural puncture headache includes epidural blood patch (EBP), which is invasive and may result in rare but severe complications. Sphenopalatine ganglion block is suggested as a simple, minimally invasive treatment for postdural puncture headache. We aimed to investigate the analgesic effect of a transnasal sphenopalatine ganglion block with local anaesthetic vs saline. ⋯ NCT03652714.
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Randomized Controlled Trial
Remifentanil and perioperative glycaemic response in cardiac surgery: an open-label randomised trial.
This study investigated whether remifentanil infusion decreased intraoperative hyperglycaemia and insulin resistance compared with intermittent fentanyl administration in patients undergoing elective cardiac surgery. ⋯ NCT02349152.
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Comparative Study
Counting train-of-four twitch response: comparison of palpation to mechanomyography, acceleromyography, and electromyography.
Train-of-four twitch monitoring can be performed using palpation of thumb movement, or by the use of a more objective quantitative monitor, such as mechanomyography, acceleromyography, or electromyography. The relative performance of palpation and quantitative monitoring for determination of the train-of-four ratio has been studied extensively, but the relative performance of palpation and quantitative monitors for counting train-of-four twitch responses has not been completely described. ⋯ Acceleromyography with the StimPod frequently underestimated train-of-four count in comparison with electromyography with TwitchView.
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Review
Perioperative considerations for transgender women undergoing routine surgery: a narrative review.
A transgender woman is a person assigned male sex at birth who identifies as a woman. With the numbers of transgender identity on the rise, encountering a transgender woman requiring routine surgery is becoming more common in anaesthetic practice. The perioperative period can be challenging for transgender women, but these challenges can be mitigated by a skilled and sensitive perioperative team. ⋯ Whilst there are anaesthetic issues relevant to both transgender women and men, there are many issues unique to transgender women. This article focuses only on considerations for the perioperative care of the transgender woman. This narrative review provides an overview of the factors influencing the safe care of the transgender woman presenting for routine surgery, including the potential social and pharmacological factors to consider, and anatomical changes to be aware of from previous gender confirming or feminisation surgeries that can influence clinical decision-making.