British journal of anaesthesia
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Ivabradine lowers heart rate (HR) without affecting contractility or vascular tone. It is licensed for HR control in chronic heart diseases. We performed a systematic review and meta-analyses to examine whether ivabradine could decrease major adverse cardiovascular events (MACE) and mortality in critically ill patients. ⋯ Prospero CRD42018086109.
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Review
Systematic review and narrative synthesis of competency-based medical education in anaesthesia.
Competency-based medical education (CBME) addresses the accountability of postgraduate training programmes to graduate specialists capable of independent practice. ⋯ Evidence on outcomes of CBME was limited to acquisition of specific competencies during training. The large number of unanswered questions and the dearth of studies across the core components of CBME suggest that we need a collaborative approach to create the evidence required to implement CBME wisely and cost effectively, to have positive impacts on patients, trainees, and healthcare systems.
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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.