Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2015
Randomized Controlled TrialCombined spinal-epidural for labor analgesia with low-dose bupi- vacaine but without any opioid in the spinal component: can we improve upon the traditional?
To compare the efficacy and safety of combined spinal-epidural (CSE, with the spinal component using low-dose heavy bupivacaine without opioid) with low-dose epidural analgesia in labor. ⋯ CSE using low-dose heavy bupivacaine without opioid required less drug consumption produced faster onset of pain control and sensory block than low-dose epidural analgesia. There were no other significant inter-group differences.
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Acta Anaesthesiol Belg · Jan 2015
Randomized Controlled Trial Comparative StudyComparison of conventional infrainguinal versus modified proximal suprainguinal approach of Fascia Iliaca Compartment Block for postoperative analgesia in Total Hip Arthroplasty. A prospective randomized study.
Fascia Iliaca Compartment Block (FICB) has been widely used as a postoperative analgesic adjunct to opioids for total hip arthroplasty (THA), either by the conventional infrainguinal approach or the modified proximal suprainguinal approach irrespective of any specific advantage of one over the other. This study was conducted to compare the analgesic efficacy of the two techniques of FICB for postoperative analgesia. The 40 patients scheduled for THA were recruited for Intervention (s) and randomized to receive FICB either by suprainguinal approach (group S) or infrainguinal approach (group I) for postoperative analgesia with 40 ml of 0.2% bupivacaine, in addition to postoperative patient controlled analgesia (PCA) with morphine. ⋯ Postoperatively, there was significant difference in time to first PCA morphine demand (356.28 ± 33.32 vs 291.48 ± 37.17, p = < 0.001, respectively) in-group S vs. group I. The postoperative morphine consumption was also significantly less in group S compared to group I at 6, 12 and 24 hours and the cumulative morphine consumption in 24 hours (6.95 ± 2.14 vs 10.50 ± 2.24, p = < 0.001 respectively) was also less. In conclusion, in THA, suprainguinal approach of FICB has a superior postoperative analgesic efficacy compared to infrainguinal approach of FICB along with significantly less morphine consumption in first 24 hours.
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Acta Anaesthesiol Belg · Jan 2015
Randomized Controlled Trial Comparative StudyA comparative evaluation of the Airtraq and King Vision video laryngoscope as an intubating aid in adult patients.
Airtraq has been shown to improve ease of intubation in patients with normal and difficult airway. King Vision video laryngoscope is a newly introduced intubating device with an attached monitor. We here hypothesized that the King Vision video laryngoscope with channeled blade performs better during intubation as compared to Airtraq. ⋯ The time required to intubate patients was significantly shorter when the King Vision video laryngoscope with channeled blade was used as compared to the Airtraq (p < 0.05). The number of attempts to successfully intubate patients was also significantly lower (p < 0.05) for the King Vision video laryngoscope than for the Airtraq. The use of the Kings Vision video laryngoscope with channeled blade should be encouraged in difficult intubation situations in adult patients with a mouth opening of more than 18 mm.
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Acta Anaesthesiol Belg · Jan 2015
Randomized Controlled TrialEvaluation of intubating conditions in children after sevoflurane induction using propofol or rocuronium bromide--a randomised, prospective, double blind study.
The use of sevoflurane without muscle relaxant for tracheal intubation has been widely investigated in children. Non-depolarizing neuromuscular blockers have long duration of action and do not provide rapid return of spontaneous ventilation. Use of suc-cinylcholine has been found to be associated with various side-effects especially in children. Therefore, we aim to evaluate the effect of propofol 1.5 mg/kg without muscle relaxant, on intubating conditions in children 2-8 yrs of age and we compare them with those achieved with rocuronium 0.6 mg/kg, at moderate sevoflurane concentration. ⋯ Propofol (1.5 mg/kg) and rocuronium (0.6 mg/kg) produced similar intubating conditions in children induced with sevoflurane.
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Acta Anaesthesiol Belg · Jan 2014
Randomized Controlled TrialThe effect of chewing lidocaine soaked gauze on intubation conditions during awake videolaryngoscopy: a randomised controlled trial in the morbidly obese.
The increasing utilisation of the videolaryngoscope for awake tracheal intubation requires development and assessment of methods to decrease the gag reflex. We hypothesised that chewing gauze soaked with lidocaine would decrease the gag reflex during awake videolaryngoscope tracheal intubation. Twenty four morbidly obese patients assessed as having a potential difficult tracheal intubation were randomised to chew gauze soaked with 20 ml of 2% lidocaine or saline for 3 minutes. ⋯ The primary outcome was the gagging score at best laryngeal visualisation, which was compared between groups with a Student's t-test. Gagging scores and hemodynamic parameters did not differ between groups, but the saline group had lower plasma levels of lidocaine after the intubation procedure. When used for awake videolaryngoscope assisted tracheal intubation of the morbidly obese, chewing lidocaine soaked gauze does not decrease the amount of gagging as compared to lidocaine aerosolisation, but does increase the plasma levels of lidocaine.