European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Comparison of Enk Fibreoptic Atomizer with translaryngeal injection for topical anaesthesia for awake fibreoptic intubation in patients at risk of secondary cervical injury: A randomised controlled trial.
Two methods of topical anaesthesia for awake fibreoptic intubation (FOI) in patients at risk of secondary cervical injury were compared: the translaryngeal injection (TLI) technique and the Enk Fibreoptic Atomizer. ⋯ Awake FOI using the TLI technique was faster and provided better topical anaesthesia with less gagging during endoscopic intubation. However, the TLI technique was also more invasive.
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Randomized Controlled Trial
The effect of intraoperative dexmedetomidine on postoperative catheter-related bladder discomfort in patients undergoing transurethral bladder tumour resection: A prospective, double-blind, randomised study.
Catheter-related bladder discomfort (CRBD) due to an indwelling urinary catheter causes postoperative distress. Dexmedetomidine is used as an anaesthetic adjuvant during general anaesthesia and has an antimuscarinic effect, which may be beneficial for the prevention and treatment of CRBD. ⋯ Intraoperative dexmedetomidine administration decreased the incidence and severity of early postoperative CRBD as well as intraoperative desflurane and postoperative opioid requirements in patients undergoing TURB.
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Randomized Controlled Trial Comparative Study
Deep sedation for endoscopic cholangiopancreatography with or without pre or intraprocedural opioids: A double-blind randomised controlled trial.
Propofol alone or combined with opioids is considered the drug of choice for sedation during endoscopic retrograde cholangiopancreatography (ERCP). ⋯ The addition of pre or intraprocedural opioids had no effect on propofol requirement for deep sedation, but patients who received fentanyl had less minor pain.
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The transversus abdominis plane block has become popular since it has been combined with ultrasound-guided techniques. In abdominal surgery, and especially in subumbilical surgery, it improves postoperative analgesia and reduces morphine consumption. Although it has been shown to be an effective technique, there are wide variations in reported doses and volumes of local anaesthetic used. ⋯ The ED50 of ropivacaine in TAP blocks in reversal of ileostomy is close to the toxic threshold. Anaesthesiologists should always be aware of the systemic toxicity risk and use weight-based doses when performing a TAP block.