British journal of anaesthesia
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Randomized Controlled Trial Comparative Study
Comparison of nebulised dexmedetomidine, ketamine, or midazolam for premedication in preschool children undergoing bone marrow biopsy.
The aim of our study was to compare the efficacy of dexmedetomidine, ketamine, and midazolam for sedative premedication administered by nebuliser 30 min before general anaesthesia in preschool children undergoing bone marrow biopsy and aspiration. ⋯ NCT02935959.
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The influence of dexmedetomidine on postoperative delirium (POD) in adult surgical patients remains controversial. We aimed to analyse whether dexmedetomidine use could decrease POD incidence in this population and its relation to timing of dexmedetomidine administration and patient age. ⋯ PROSPERO: CRD42017072380.
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Observational Study
Prediction of outliers in pain, analgesia requirement, and recovery of function after childbirth: a prospective observational cohort study.
Prediction models to identify parturients who experience protracted pain, prolonged opioid use, and delayed self-assessed functional recovery are currently inadequate. ⋯ Labour induction and elevated numerical rating score for pain are predictive of poor recovery after childbirth. Further research is necessary to determine whether modification would benefit mothers at risk for poor recovery.
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Observational Study
Evaluation of the analgesia nociception index for monitoring intraoperative analgesia in children.
Intraoperative analgesia is still administered without guidance. Anaesthetists decide upon dosing on the basis of mean population opioid pharmacological studies and in response to variations in haemodynamic status. However, those techniques have been shown to be imprecise. We assessed the diagnostic value of monitoring the analgesia nociception index (ANI) to detect surgical stimulation in children. ⋯ ANI has diagnostic value for detecting surgical stimuli in children.
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Observational Study
Management of rocuronium neuromuscular block using a protocol for qualitative monitoring and reversal with neostigmine.
Neuromuscular block using subjective monitoring and neostigmine reversal is commonly associated with postoperative residual neuromuscular block. We tested whether a protocol for the management of neuromuscular block that specified appropriate dosing and optimal neostigmine reversal was associated with a reduction in postoperative residual neuromuscular block. ⋯ NCT02660398.