British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Category generation testing in the search for implicit memory during general anaesthesia.
We gave auditory examples of two semantic categories through headphones to 100 surgical patients anaesthetized with propofol and enflurane. This presentation was made during certain stages of the procedure, potentially associated with arousal, and during steady-state anaesthesia. Postoperative review using category generation tests showed successful priming in a pre-induction group but no evidence of implicit memory in the anaesthetized groups. These results suggest that timing an auditory input to coincide with surgical stimulation does not increase the probability of retrieval of information by this type of testing.
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Randomized Controlled Trial Clinical Trial
Clinical assessment of the single use laryngeal mask airway--the LMA-unique.
We conducted a clinical comparison of the laryngeal mask airway (LMA) and the new single use PVC LMA (LMA-Unique) in 100 fasted adult patients undergoing elective surgery. Patients were allocated to one of two groups: group 1 (n = 50) was managed by two consultants and group 2 by two trainee anaesthetists. Airway management was randomized prospectively within each group, and cuff pressure in both devices was maintained at a maximum of 50 mm Hg with upward size substitution if leaks persisted during intermittent positive pressure ventilation (IPPV). ⋯ At fibreoptic laryngoscopic examination, the vocal cords or arytenoids, or both, could be seen in 92% of patients in group 1 and in 90% of patients in group 2. Immediate throat soreness was reported in four patients in group 1 and in seven in group 2. The results suggest that the LMA-Unique was similar in clinical performance to the LMA.
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Randomized Controlled Trial Clinical Trial
Ease of placement of the laryngeal mask during manual in-line neck stabilization.
We studied 20 patients, in a randomized, cross-over study, to determine if manual in-line stabilization of the head and neck altered the ease of insertion of the laryngeal mask and its correct positioning. After induction of anaesthesia and neuromuscular block, the laryngeal mask was inserted and adequacy of ventilation assessed while the patient's head and neck were placed in the Magill and manual in-line positions, in turn. Ease of insertion of the mask was assessed using a 10-cm visual analogue scale (VAS) and position using a fibreoptic bronchoscope. ⋯ Insertion was always more difficult (P < 0.001; 95% CI for difference in VAS 20-55 mm) and time for insertion longer (P < 0.001; 95% CI for difference 4.9-11.9 s) in the manual in-line position compared with the Magill position. The incidence of a suboptimal position was significantly higher for the manual in-line position (seven patients) than for the Magill position (15 patients) (P < 0.005). We conclude that in paralysed patients, manual in-line stabilization of the head and neck made insertion of the laryngeal mask and its correct positioning more difficult.
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Comment Letter Case Reports
Sevoflurane for intubation of an infant with croup.