British journal of anaesthesia
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Multicenter Study
Assessment of healthcare professionals' knowledge of managing emergency complications in patients with a tracheostomy.
Ear, nose, and throat (ENT) surgeons perform the majority of surgical tracheostomies. Intensive care anaesthetists are increasingly performing bedside percutaneous tracheostomy. The objectives of this study were to characterize emergency complications of tracheostomy and to ascertain healthcare professionals' knowledge of life-saving strategies for the patient with a tracheostomy. ⋯ Knowledge of tracheostomy-related emergencies appears to be insufficient among non-ENT healthcare professionals. This needs to be addressed in order to maximize patient safety.
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Multicenter Study Comparative Study
Regional anaesthesia for carotid endarterectomy: an audit over 10 years.
The aim of this retrospective study was to compare the failure rates and the frequency of anaesthesia-related complications of two different methods of regional anaesthesia used for carotid endarterectomy--cervical epidural (CE) anaesthesia and cervical plexus block (CPB). ⋯ Both methods of regional anaesthesia are acceptable for carotid artery surgery. CPB is associated with a significantly lower frequency of anaesthesia-related complications and should therefore be considered the anaesthetic of choice. CE anaesthesia should not be performed except in extenuating circumstances such as variant anatomy or the requirement for more extensive surgery.
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Randomized Controlled Trial Multicenter Study Comparative Study
Single-dose aprepitant vs ondansetron for the prevention of postoperative nausea and vomiting: a randomized, double-blind phase III trial in patients undergoing open abdominal surgery.
The neurokinin(1) antagonist aprepitant is effective for prevention of chemotherapy-induced nausea and vomiting. We compared aprepitant with ondansetron for prevention of postoperative nausea and vomiting. ⋯ Aprepitant was non-inferior to ondansetron in achieving complete response for 24 h after surgery. Aprepitant was significantly more effective than ondansetron for preventing vomiting at 24 and 48 h after surgery, and in reducing nausea severity in the first 48 h after surgery. Aprepitant was generally well tolerated.
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Randomized Controlled Trial Multicenter Study
Iontophoretic transdermal system using fentanyl compared with patient-controlled intravenous analgesia using morphine for postoperative pain management.
The fentanyl iontophoretic transdermal system (fentanyl ITS) enables needle-free, patient-controlled analgesia for postoperative pain management. This study compared the efficacy, safety, and ease of care of fentanyl ITS with patient-controlled, i.v. analgesia (PCIA) with morphine for postoperative pain management. ⋯ Fentanyl ITS and morphine PCIA were comparably effective and safe.
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Randomized Controlled Trial Multicenter Study Comparative Study
Multicentre evaluation of the adenosine agonist GR79236X in patients with dental pain after third molar extraction.
Adenosine is analgesic in humans, and the selective adenosine A1 receptor agonist GR79236X has significant anti-nociceptive activity in an animal pain model of inflammatory pain. ⋯ We found no evidence of efficacy of GR79236 compared with placebo, but the active control diclofenac was effective. It is possible that a higher dose of GR79236 might have been effective or that i.v. administration of this drug does not achieve appropriate concentrations in the brain or peripheral nerves.