European journal of anaesthesiology
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Former studies revealed conflicting information on the usefulness of intraoperative monitoring of visual evoked potentials. This study was designed to evaluate the characteristics of visual evoked potential recording in surgically anaesthetized patients using the modality of steady-state visual evoked potentials. ⋯ We conclude from this study, that steady-state visual evoked potential recordings in the surgically anaesthetized patient appeared to be more stable compared to our earlier findings using transient visual evoked potentials. However, further efforts are necessary to improve the stability of the recordings during surgery and thus allow for a more reliable intraoperative monitoring of visual pathways in routine clinical practice.
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Only regular training of anaesthetic personnel ensures safe and reliable application of cricoid pressure during rapid sequence induction of anaesthesia. Previously described training devices are either complicated, too expensive and usually unavailable, or they are very simple and do not correctly simulate the process of applying cricoid force. We designed and tested a cricoid pressure trainer with real-time display of applied force. The device is easy to assemble at relatively little cost with material widely available. It allows effective biofeedback training of the force required during the Sellick manoeuvre and can be used for routine staff assessment. ⋯ Our biofeedback cricoid pressure trainer is effective in the assessment and training of correct cricoid pressure application by anaesthetic personnel.
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Randomized Controlled Trial Clinical Trial
Airway management by first responders when using a bag-valve device and two oxygen-driven resuscitators in 104 patients.
To evaluate the capability of first responders to ensure an airway and ventilate the lungs of a patient employing a bag-valve device and two oxygen-driven resuscitators. ⋯ The use of an oxygen-driven device improves the ability of first responders to secure an airway and reduce gastric insufflation, even when distracted. Oxylators perform significantly better (P < 0.0001) than the bag-valve device.
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Randomized Controlled Trial Comparative Study Clinical Trial
No difference in electroencephalographic power spectra or sensory-evoked potentials in patients anaesthetized with desflurane or sevoflurane.
Hitherto, neither desflurane nor sevoflurane, with similar physicochemical properties, have been compared with regard to their effects on the central nervous system. We compared the effects of desflurane and sevoflurane on electrical cortical activity and sensory transmission at two anaesthetic concentrations in patients undergoing hysterectomy. ⋯ Both desflurane and sevoflurane possess a similar profile with regard to their hypnotic effects and a similar outline in depressing propagation within the sensory nervous system. Cortical nervous effects are mirrored closely in heart rate and systolic blood pressure.
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The perception of a looming manpower shortage led the French College of Anaesthesiologists (CFAR) and the French Society of Anaesthesia and Intensive Care (SFAR), with assistance from the National Institute for Demographic Studies (INED), to conduct a national survey of French anaesthesiologists in order to determine precise physician characteristics data, analyse professional practices and project future service provision. ⋯ Future service provision must take account of falling numbers of new anaesthesiologists and an increase in retirements, but must also include changes in working practices, such as the European Working Time Directive. If anaesthesia manpower shortages are to be avoided, there must be a restructuring of the work-place, a redefinition of tasks and improved management of working time.