British journal of anaesthesia
-
Randomized Controlled Trial
Intravenous infusion of lidocaine significantly reduces propofol dose for colonoscopy: a randomised placebo-controlled study.
Propofol use during sedation for colonoscopy can result in cardiopulmonary complications. Intravenous lidocaine can alleviate visceral pain and decrease propofol requirements during surgery. We tested the hypothesis that i.v. lidocaine reduces propofol requirements during colonoscopy and improves post-colonoscopy recovery. ⋯ NCT 02784860.
-
Several case reports have described anatomical variations that can cause difficulty with front-of-neck airway access, such as major vessels anterior to the trachea. The prevalence of these anomalies is unknown. ⋯ It is common for patients to have some portion of a major vessel anterior to the trachea at sites where an emergency tracheostomy might be performed.
-
Comparative Study
Laryngeal handshake technique in locating the cricothyroid membrane: a non-randomised comparative study.
Evaluation of the anterior neck anatomy is used to identify the cricothyroid membrane (CTM) before front of neck airway access. This has been traditionally performed using palpation which results in misidentification of the CTM in a high proportion of subjects. The 'laryngeal handshake' is currently advocated by the Difficult Airway Society as the method to identify the CTM. We sought to investigate the accuracy of this technique in females. ⋯ The 'laryngeal handshake' method of palpation is more accurate but takes longer than conventional palpation technique in locating the CTM and the midline. This is of particular relevance if a vertical incision is required to perform front of neck access when anatomy is indistinct.
-
Impaired consciousness has been associated with impaired cortical signal propagation after transcranial magnetic stimulation (TMS). We hypothesised that the reduced current propagation under propofol-induced unresponsiveness is associated with changes in both feedforward and feedback connectivity across the cortical hierarchy. ⋯ Propofol-induced loss of consciousness is associated with impaired hierarchical feedforward connectivity assessed by EEG after occipital TMS.