Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2013
Randomized Controlled Trial Comparative StudyA randomized controlled comparison of epidural analgesia and combined spinal-epidural analgesia in a private practice setting: pain scores during first and second stages of labor and at delivery.
There has been no prospective evaluation of combined spinal-epidural (CSE) analgesia in a private practice setting and few studies have focused on pain relief during the second stage of labor and at delivery. In this randomized controlled trial, we compared verbal pain scores during the first and second stages of labor and at delivery in women receiving CSE or traditional epidural analgesia at a busy private maternity hospital. ⋯ Compared with traditional epidural labor analgesia, CSE analgesia provided better first-stage analgesia despite fewer epidural top-up injections by an anesthesiologist.
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Anesthesia and analgesia · Mar 2013
Randomized Controlled Trial Comparative StudyCuff inflation-supplemented laryngoscope-guided nasal intubation: a comparison of three endotracheal tubes.
Softer endotracheal (ET) tubes are more difficult to navigate in the oropharynx than the stiffer polyvinyl chloride (PVC) tubes during nasotracheal intubation (NTI). Cuff inflation has been used to guide PVC tubes into the laryngeal inlet during blind NTI, but it has not been tested when performing NTI under direct laryngoscopic guidance. We assessed the role of cuff inflation in improving oropharyngeal navigation of 3 ET tubes of varying stiffness during direct laryngoscope-guided NTI. Simultaneously, we also assessed and compared the nasotracheal navigability and incidence of nasal injury with these ET tubes during cuff inflation-supplemented, laryngoscope-guided NTI. ⋯ The cuff inflation technique consistently improved the oropharyngeal insertion of the 3 ET tubes of varying stiffness during direct laryngoscope-guided NTI. Supplemented with the cuff inflation technique, the SWR ET tube seems to be better than the PVC and WR ET tubes in terms of complete nasotracheal navigability and less perioperative nasal injury.
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Anesthesia and analgesia · Mar 2013
Randomized Controlled Trial Comparative StudyA randomized comparison of ropivacaine 0.1% and 0.2% for continuous interscalene block after shoulder surgery.
The optimal concentration of ropivacaine for continuous interscalene block after shoulder surgery is currently unknown. ⋯ These results suggest that ropivacaine 0.2% provides more effective analgesia than ropivacaine 0.1% during the first 24 hours for continuous interscalene block after shoulder surgery.