European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Continuous spinal analgesia or opioid-added continuous epidural analgesia for postoperative pain control after hip replacement.
Continuous spinal anaesthesia and continuous epidural anaesthesia are both able to provide adequate postoperative pain relief. Combining local anaesthetics and opioids results in synergistic effects. The purpose of this randomized, prospective study was to compare quality of analgesia, side-effects and patient's satisfaction between spinal bupivacaine alone and epidural bupivacaine with sufentanil postoperatively. ⋯ Continuous spinal analgesia with bupivacaine alone and continuous epidural analgesia with bupivacaine/sufentanil are both effective for postoperative pain relief after hip replacement. Those patients in the epidural group reported better analgesia but had a higher rate of postoperative nausea and vomiting. Efficacy of pain therapy did not correlate with patient satisfaction.
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For use in a magnetic resonance (MR) scanning room infusion pumps must be MR safe and compatible. This study tested two commonly used infusion pumps (Alaris P6000 and Alaris Asena-GH) to determine if they met these criteria. ⋯ Whilst the pumps cannot strictly be termed MR safe or compatible at 100 Gauss we have demonstrated that flow rates are unchanged and that, for the Alaris Asena-GH, the effect on the occlusion pressure alarm is unlikely to have patient safety implications.
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Randomized Controlled Trial Comparative Study Clinical Trial
Suxamethonium administration prolongs the duration of action of subsequent rocuronium.
Rocuronium may be given to patients for intubation and also after they have received suxamethonium for intubation. The neuromuscular profile of rocuronium given after recovery from suxamethonium may not be identical to that when rocuronium has been given alone. The neuromuscular effects of suxamethonium and rocuronium, and their effects on intraocular pressure (IOP), heart rate (HR) and arterial pressure were also recorded. ⋯ Previous suxamethonium administration decreases the onset time and increases the duration of action of rocuronium. Unlike suxamethonium, rocuronium has few cardiovascular effects and causes little change in IOP.
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Randomized Controlled Trial Comparative Study Clinical Trial
Pain control with low-dose alfentanil in children undergoing minor abdominal and genito-urinary surgery.
The aim of this study was to investigate the quality of intra- and postoperative analgesia obtained by alfentanil compared to that produced by peripheral blockade in children. ⋯ It was concluded that a low-dose, intravenous bolus of alfentanil may be an efficient alternative to peripheral nerve blockade in controlling pain during and after minor abdominal and genito-urinary surgery.
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Clinical Trial
Ultrasound-guided cannulation of the internal jugular vein in critically ill patients positioned in 30 degrees dorsal elevation.
Catheterization of the internal jugular vein is traditionally performed with the patient lying flat or in the Trendelenburg position. This puts patients with elevated intracranial pressure at risk of cerebral herniation. The objective of this study was to assess the safety of real-time ultrasound-guided catheterization of the internal jugular vein in ventilated patients with the patient positioned in a 30 degrees head-up position. ⋯ Ultrasound-guided cannulation of the internal jugular vein in ventilated ICU patients can be performed successfully with the patient positioned in 30 degrees dorsal elevation. Potentially deleterious position changes can thus be avoided in high-risk patients.