European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
A comparison of the use of Trachlight and Eschmann multiple-use introducer in simulated difficult intubation.
The Eschmann multiple-use introducer is widely used in the management of difficult intubations. Transillumination of the neck is less commonly used. We conducted a randomized crossover study comparing the Trachlight lightwand and Eschmann multiple-use introducer in simulated difficult intubation. ⋯ The Trachlight is a potentially useful alternative to the Eschmann multiple-use introducer in difficult intubation.
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Randomized Controlled Trial
Preventing pain during injection of propofol: effects of a new emulsion with lidocaine addition.
Previous studies found that lidocaine addition to propofol long-chain triglyceride was associated with a lower incidence of injection pain than medium-chain triglyceride/long-chain triglyceride formulation, but the incidence was still high (31-40%). Our study investigated whether the incidence of injection pain could be further reduced by the addition of lidocaine (10 mg, 20:1) to propofol medium-chain triglyceride/long-chain triglyceride. ⋯ Premixing propofol medium-chain triglyceride/long-chain triglyceride with lidocaine is one of the most effective measures currently available to reduce the incidence of injection pain in sedated patients during regional anaesthesia.
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Randomized Controlled Trial
Acupressure for postoperative nausea and vomiting in gynaecological patients receiving patient-controlled analgesia.
To evaluate the effectiveness of acupressure in preventing nausea and vomiting in patients undergoing gynaecological operations and receiving a patient-controlled analgesia device. ⋯ Acupressure at the P6 meridian point is an effective alternative for the prevention of nausea and vomiting in patients receiving patient-controlled analgesia with morphine after gynaecological surgery.
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Clinical Trial
Effect of alpha-stat vs. pH-stat strategies on cerebral oximetry during moderate hypothermic cardiopulmonary bypass.
This study was undertaken to compare the effect of alpha-stat vs. pH-stat strategies for acid-base management on regional cerebral oxygen saturation (RsO2) in patients undergoing moderate hypothermic haemodilution cardiopulmonary bypass (CPB). ⋯ During moderate hypothermic haemodilutional CPB, the RsO2 was significantly higher during the pH-stat than during the alpha-stat strategy. However, the RsO2 during pH-stat management was significantly higher than the baseline RsO2 value in the awake patient breathing room air, denoting luxury cerebral perfusion. In contrast, the RsO2 during alpha-stat was only slightly higher than the baseline RsO2, suggesting that the alpha-stat strategy avoids luxury perfusion, but can maintain adequate cerebral oxygen supply-demand balance during moderate hypothermic haemodilutional CPB.
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National Institute for Clinical Excellence guidance states that 2D imaging ultrasound guidance should be used when inserting internal jugular venous lines in adults and children in the elective situation and should be considered in most clinical circumstances requiring central venous catheter insertion. This survey explored the availability, training and use of ultrasound devices by consultant paediatric anaesthetists in the UK. ⋯ National Institute for Clinical Excellence guidance on the use of ultrasound locating devices for placing central venous catheters is not universally adhered to. Among the reasons for this are problems with availability of equipment, lack of training in the use of ultrasound and non-acceptance of the guidelines.