European journal of anaesthesiology
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Meta Analysis
Dexmedetomidine vs. total intravenous anaesthesia in paediatric emergence delirium: A network meta-analysis.
Emergence delirium is a common complication in paediatric anaesthesia associated with significant morbidity. Total intravenous anaesthesia (TIVA) and intra-operative dexmedetomidine as an adjuvant to sevoflurane anaesthesia can both reduce the incidence of emergence delirium compared with sevoflurane alone, but no studies have directly compared their relative efficacy. ⋯ Clinical judgement, considering the patient's risk factors for the development of clinically significant outcomes such as emergence delirium and PONV, should be used when choosing between TIVA and sevoflurane with adjuvant dexmedetomidine. These findings are limited by the low quality of evidence (conditional recommendation).
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Randomized Controlled Trial
Videolaryngoscopy vs. Direct Laryngoscopy for Elective Airway Management in Paediatric Anaesthesia: A prospective randomised controlled trial.
The indirect visualisation of the glottic area with a videolaryngoscope could improve intubation conditions which may possibly lead to a higher success rate of the first intubation attempt. ⋯ The first attempt intubation success rate was lower in the videolaryngoscopy group in comparison to the direct laryngoscopy group. The time needed for successful intubation with videolaryngoscopy was longer compared with direct laryngoscopy.
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Observational Study
Swallowing ability and intra-oral water-retaining ability during moderate propofol sedation in healthy human volunteers: A prospective observational study.
The cough reflex or aspiration under monitored anaesthesia care might be associated with sedative-induced changes in swallowing and intra-oral water-retaining abilities. ⋯ Moderate propofol sedation decreases water-retaining ability but has no effect on voluntary swallowing. Ensuring that patients can respond under sedation may effectively prevent the unexpected cough reflex and aspiration by enabling occasional voluntary swallowing.