European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Discomfort on injection: a comparison between two formulations of propofol.
A randomized double-blind controlled trial was performed to determine if there was a difference in discomfort on injection between two preparations of propofol. A long-chain triglyceride preparation (LCT-propofol (Fresenius)) was compared against a medium- and long-chain triglyceride preparation (MCT/LCT-propofol (BBraun)). ⋯ There is a significant decrease in the incidence of discomfort with MCT/LCT-propofol compared with LCT-propofol. This difference is more marked in subjects reporting severe discomfort.
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Subarachnoid haemorrhage due to rupture of cerebral aneurysms is a multisystem disease. Treatment of the condition in the past has relied on craniotomy and clipping of the aneurysm to prevent a recurrent haemorrhage. ⋯ Anaesthetists need to be familiar with this procedure and the management of potential complications. This review provides an overview such considerations.
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Measurement of central blood volumes (CBV), such as global end-diastolic volume (GEDV) and right ventricular end-diastolic volume (RVEDV) are considered appropriate estimates of intravascular volume status. However, to apply those parameters for preload assessment in mechanically ventilated patients, the influence of tidal volume (TV) and positive endexpiratory airway pressure (PEEP) on those parameters must be known. ⋯ Application of PEEP decreases CBV and SV. Augmenting TV reduces SV but not CBV. There is a moderate correlation between parameters of CBV and cardiac performance.
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Comparative Study
Attitudes of anaesthetists to awareness and depth of anaesthesia monitoring in the UK.
Awareness with postoperative recall of intraoperative events is a rare but serious complication of general anaesthesia. This survey investigated the attitude of anaesthetists in the UK to awareness and depth of anaesthesia monitoring. ⋯ Anaesthetists tend not to view awareness as a serious problem. Although most accept that clinical signs are unreliable indicators of awareness, few believe that monitors of anaesthetic depth should be used for routine cases.