British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Esmolol prevents movement and attenuates the BIS response to orotracheal intubation.
Beta-adrenergic agonists enhance behavioural and electroencephalographic arousal reactions. We explored whether adding esmolol, a short-acting beta(1)-adrenoceptor antagonist, to propofol anaesthesia modified the bispectral index (BIS) during induction of anaesthesia and orotracheal intubation. ⋯ Esmolol not only attenuated haemodynamic and somatic responses to laryngoscopy and orotracheal intubation, but also prevented BIS arousal reactions in patients anaesthetized with propofol.
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Multicenter Study
Patient satisfaction with anaesthesia care: development of a psychometric questionnaire and benchmarking among six hospitals in Switzerland and Austria.
We describe the development and comparison of a psychometric questionnaire on patient satisfaction with anaesthesia care among six hospitals. ⋯ A psychometric questionnaire on patient satisfaction with anaesthesia care must cover areas such as patient information, involvement in decision-making, and contact with the anaesthetist. The assessment using summed scores for dimensions is more informative than a global summed rating. There were significant differences between hospitals. Moreover, the high problem scores indicate a great potential for improvement at all hospitals.
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Randomized Controlled Trial Clinical Trial
Pharmacogenetics of codeine metabolism in an urban population of children and its implications for analgesic reliability.
Codeine analgesia is wholly or mostly due to its metabolism to morphine by the cytochrome P450 enzyme CYP2D6, which shows significant genetic variation in activity. The aims of this study were to investigate genotype, phenotype and morphine production from codeine in children undergoing adenotonsillectomy, and to compare analgesia from codeine or morphine combined with diclofenac. ⋯ Reduced ability for codeine metabolism may be more common than previously reported. Plasma morphine concentration 1 h after codeine is very low, and related to phenotype. Codeine analgesia is less reliable than morphine, but was not well correlated with either phenotype or plasma morphine in this study.
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Parkinson's disease is an increasingly common disease of elderly patients who present a particular anaesthetic challenge. This review explores the epidemiology, aetiology, pathogenesis, and pathophysiology of the condition, particularly the possible role of genetic factors. ⋯ Particular anaesthetic problems in patients with Parkinson's disease are respiratory, cardiovascular, and neurological. Potential drug interactions are described and recommendations are made about suitable anaesthetic techniques.