Articles: adult.
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Randomized Controlled Trial
Effect of cricoid pressure on placement of the I-gel(™) : a randomised study.
We studied 40 adult patients to see if cricoid pressure affected placement of the I-gel(™). In a randomised crossover design, the i-gel was placed with and without cricoid pressure, and we compared the success rate of adequate ventilation through the i-gel, time to placement and the rate of optimal position of the device between the two circumstances. ⋯ The time to achieve adequate ventilation was significantly longer (p < 0.001) with cricoid pressure than without (median difference 8 s; 95% CI for median difference 3-12 s). Cricoid pressure significantly decreases the success rate of ventilation through the i-gel, but the success rate of ventilation through the i-gel is reasonably high.
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Randomized Controlled Trial
Exploring the impact of augmenting sedation assessment with physiologic monitors.
Pharmacological sedation is a necessary tool in the management of critically ill, mechanically ventilated patients. The intensive care unit (ICU) sedation strategy is to use the least amount of medication to meet safety and comfort goals. Titration of pharmacological agents is currently guided by clinical assessment tools. The purpose of this study was to determine whether the addition of a neurophysiological monitor, bispectral index (BIS), aided the ICU nurse in reducing the amount of drug used, compared to a clinical tool alone, in a general critical care population. ⋯ The clinical evaluation of depth of sedation remains the most reliable method for the titration of pharmacological sedation in the critical care unit. However, BIS-augmented assessment is helpful in reducing the amount of propofol and narcotic medication used and may be considered an adjunct when these agents are utilised.
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Randomized Controlled Trial Comparative Study
Efficacy of AccuVein to Facilitate Peripheral Intravenous Placement in Adults Presenting to an Emergency Department: A Randomized Clinical Trial.
In the emergency department (ED), intravenous (IV) catheter placement is one of the most frequent interventions and may be a real challenge in some conditions. Improvement of the success rate with new technology represents a great opportunity. This randomized controlled trial aimed to show the superiority of AccuVein to cannulate veins in adults compared to routine care. ⋯ Use of the AccuVein did not improve IV cannulation in nonselected ED patients.
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Randomized Controlled Trial
Usefulness of the compression-adjusted ventilation for adequate ventilation rate during cardiopulmonary resuscitation.
To perform high-quality cardiopulmonary resuscitation (CPR), high-quality chest compression and ventilation support should be performed. However, many providers still have not maintained an adequate ventilation rate but hyperventilated during CPR. Thus, this study was conducted to verify that the compression-adjusted ventilation (CAV) would be a more accurate ventilation method compared with the conventional ventilation (CV). ⋯ In comparison with the CV, the CAV is a more accurate method for maintenance of an adequate ventilation rate.
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Journal of anesthesia · Aug 2014
Randomized Controlled TrialPlasma ropivacaine concentrations after ultrasound-guided transversus abdominis plane block for open retropubic prostatectomy.
Ropivacaine-induced vasoconstriction may affect the early absorption speed of ropivacaine; however, the effects of dose on pharmacokinetics following transversus abdominis plane (TAP) block have not been studied. In this study, we have examined plasma ropivacaine concentrations following TAP block with various ropivacaine concentrations (0.25, 0.5, and 0.75 %). ⋯ Ropivacaine concentration did not alter pharmacokinetic profile following TAP blocks.