European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Comparison of local anaesthesia with dexmedetomidine sedation and general anaesthesia during septoplasty.
To compare general anaesthesia and local anaesthesia with dexmedetomidine on the basis of postoperative pain and surgical bleeding after septoplasties. ⋯ Septoplasty performed under local anaesthesia with dexmedetomidine sedation resulted in less surgical bleeding, less postoperative pain, a more stable haemodynamic state, less nausea-vomiting, a shorter recovery period and a higher level of anaesthesia satisfaction.
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Randomized Controlled Trial Comparative Study
Reinforced laryngeal mask airway compared with endotracheal tube for adenotonsillectomies.
The endotracheal tube (ETT) has traditionally been considered the best airway device during adenotonsillectomy because a well protected and secured airway is provided. This has been challenged by the introduction of the reinforced laryngeal mask airway (RLMA). It does not kink, is less traumatic during insertion and better tolerated during emergence. The purpose of this study was to compare the use of the RLMA with ETT with regards to postoperative pain, nausea, vomiting and perioperative efficacy in a series of children due for adenotonsillectomy. ⋯ The RLMA, when feasible, is a well tolerated and effective alternative to the ETT for use during adenotonsillectomies in children, with beneficial effects on airway irritations, operating room efficiency and early postoperative pain.
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Letter
Residual paralysis following a single dose of atracurium: results from a quality assurance trial.
Schreiber demonstrated a 27% incidence of PORC (Post-operative Residual Curarization/Paralysis = TOF ratio <0.9) after surgery between 60 and 90 minutes long.
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Multicenter Study
A simplified risk score to predict difficult intubation: development and prospective evaluation in 3763 patients.
Despite the presence of numerous preoperative tests to predict a difficult airway, there is no reliable bedside method. The aim of this study was to create and verify a simplified risk model with an acceptable discriminating power. ⋯ The new simplified multivariate risk score for difficult intubation may prove to be useful in clinical practice for predicting a difficult airway. Presence of upper front teeth, a history of difficult intubation, any Mallampati status different from '1' and equal to '4' and mouth opening less than 4 cm are independent risk factors for difficult endotracheal intubation. With each of these risk factors, the likelihood increases from 0 (when no risk factor is present) to 17% (when four or five factors are present).
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Randomized Controlled Trial Comparative Study
Postoperative efficacies of femoral nerve catheters sited using ultrasound combined with neurostimulation compared with neurostimulation alone for total knee arthroplasty.
Neurostimulation is commonly used to perform femoral nerve block. Ultrasound can be used to identify nerve structures and guide needle placement. The aim of this study was to compare postoperative analgesic efficiency when femoral nerve catheters were sited using ultrasound (in-plane approach) combined with neurostimulation or neurostimulation alone, for total knee arthroplasty. ⋯ Continuous perineural femoral catheter placement using ultrasound combined with neurostimulation and an in-plane approach reduces total doses of local anaesthetic, morphine consumption and improves postoperative pain management by comparison with neurostimulation alone.