European journal of anaesthesiology
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Comparative Study Clinical Trial
The correlation between the Richmond agitation-sedation scale and bispectral index during dexmedetomidine sedation.
The primary objective of sedation in the critically ill patient is to achieve security and comfort. The routine use of standardized and validated sedation scales and monitors are needed. The Richmond agitation sedation scale has been used but some patients cannot be evaluated with subjective assessment tools such as the Richmond agitation sedation scale because they lack motor responsiveness due to therapeutic paralysis or because they are receiving deep sedation. We aimed to assess the correlation of bispectral index with Richmond agitation sedation scale during dexmedetomidine sedation and evaluate the use of the bispectral index in monitoring the levels of sedation in intensive care patients. ⋯ Richmond agitation sedation scale levels significantly correlated with bispectral index values during dexmedetomidine sedation in critically ill patients requiring mechanical ventilation in the intensive care unit.
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To assess the knowledge, beliefs and attitudes of anaesthesia providers on the patients' possible intraoperative visual experiences during cataract surgery under local anaesthesia. ⋯ The majority of anaesthesia providers in the USA, UK and Singapore are aware that patients may experience a variety of visual sensations during cataract surgery under regional or topical anaesthesia. Those who have previously managed patients undergoing cataract surgery under topical anaesthesia are more likely to believe this compared to those who have not.
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Letter Case Reports
Epidural in labour: easy technique, failed analgesia.
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Randomized Controlled Trial Comparative Study
The effects of sufentanil or morphine added to hyperbaric bupivacaine in spinal anaesthesia for caesarean section.
The quality of spinal anaesthesia, often used for Caesarean section, can be improved by adding an opioid to the local anaesthetic. This study compared the quality of anaesthesia, postoperative analgesia, and adverse effects on mother and neonate when either sufentanil 5 microg or morphine 0.2 mg was added to intrathecal hyperbaric bupivacaine for Caesarean section. ⋯ The addition of 5 microg sufentanil or 0.2 mg morphine to hyperbaric bupivacaine for Caesarean section both provided safe and effective anaesthesia. Morphine increased the duration of postoperative analgesia compared with sufentanil without increasing maternal or neonatal side-effects.
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Comparative Study
The effect of a remifentanil bolus on the bispectral index of the EEG (BIS) in anaesthetized patients independently from intubation and surgical stimuli.
Remifentanil boluses are used in different clinical situations and the effects on bispectral index monitoring are unclear. We analysed the effect of a remifentanil bolus on the bispectral index of the electroencephalogram (bispectral index) under total intravenous anaesthesia with propofol and remifentanil. ⋯ There was a significant reduction in the areas under the curve between 90-120 s following the bolus. Heart rate and blood pressure also showed significant reductions. Thus, remifentanil bolus given under total intravenous anaesthesia with propofol and remifentanil decreases bispectral index, an effect independent of intubation and surgical stimuli.