Indian journal of anaesthesia
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The highly lipid-soluble opioids, sufentanil and fentanyl, are used in combination with low-concentration bupivacaine to provide combined spinal epidural (CSE) analgesia during labour. We designed a prospective, randomized, single-blind study to compare the efficacy of these two opioids with bupivacaine in terms of the quality of analgesia, side-effects and maternal and foetal outcome. ⋯ We conclude that combined spinal epidural using sufentanil and fentanyl achieved high patient satisfaction and excellent labour analgesia without serious maternal or neonatal side-effects. Sufentanil provided a significantly longer duration of labour analgesia compared with fentanyl.
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The flexible fibreoptic bronchoscope and bonfils rigid intubation endoscope are being widely used for difficult intubations. ⋯ In female adults under general anaesthesia, bonfils rigid intubation endoscope and flexible fibreoptic bronchoscope require a similar time for successful orotracheal intubation and cause a similar magnitude of haemodynamic response.
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The objective of the study was to compare the performance of i-gel supraglottic airway with cLMA in difficult airway management in post burn neck contracture patients and assess the feasibility of i-gel use for emergency airway management in difficult airway situation with reduced neck movement and limited mouth opening. ⋯ The i-gel is cheap, effective airway device which is easier to insert and has better clinical performance in the difficult airway management of the airway in the post burn contracture of the neck. Our study shows that i-gel is feasible for emergency airway management in difficult airway situation with reduced neck movement and limited mouth opening in post burn neck.
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A case of unknown compound poisoning is presented. It was initially treated as organophosphate poisoning with lack of response. A timely diagnosis of acute methaemoglobinaemia and iatrogenic atropine toxicity was made based on clinical evaluation. Treatment of methaemoglobinaemia using oral methylene blue and of atropine toxicity with supportive measures could save the patient.
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Central venous catheters (CVC) are associated with mechanical, infectious and thrombotic complications. ⋯ Bleeding complications occurred more frequently with IJV insertions and infectious complications occurred more commonly in cannulae that were left in situ for longer than 7 days.