European journal of anaesthesiology
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Randomized Controlled Trial Clinical Trial
The effects of sevoflurane, isoflurane and desflurane on QT interval of the ECG.
To determine if there is any significant difference between the effects of desflurane, isoflurane and sevoflurane on the QT interval, QT dispersion, heart rate corrected QT interval and QTc dispersion of the electrocardiogram. ⋯ Sevoflurane, isoflurane and desflurane all prolonged QTd, QTc and QTcd but there were no significant intergroup differences.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of cuff-pressure changes in LMA-Classic and the new Soft Seal laryngeal masks during nitrous oxide anaesthesia in spontaneous breathing patients.
There are concerns over the intra-cuff pressure of the laryngeal mask and laryngopharyngeal morbidity. In a randomized study, the authors compared cuff-pressure changes in the LMA-Classic and the new disposable Soft Seal laryngeal mask during nitrous oxide anaesthesia. ⋯ During nitrous oxide anaesthesia, cuff pressure increases in the LMA-Classic mask were significantly higher than those of the Soft Seal laryngeal mask. Trauma to patients, as assessed by the incidence of sore throat in the early postoperative period was significantly higher in the LMA-Classic group. Cuff pressures should be monitored during nitrous oxide anaesthesia when LMA-Classic is used but to do so is of less importance when using the disposable Soft Seal laryngeal mask.
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Randomized Controlled Trial Clinical Trial
The effect of remifentanil on the middle latency auditory evoked response and haemodynamic measurements with and without the stimulus of orotracheal intubation.
Changes in the middle latency auditory evoked response following the administration of opioids have been shown. However, it remains unclear as to whether these changes are due to a direct depressant effect of opioids on the middle latency auditory evoked response itself, or an indirect effect on account of their action in attenuating central nervous system arousal associated with noxious stimuli. By comparing changes in the middle latency auditory evoked response in intubated and non-intubated patients, receiving saline or remifentanil in different doses, this study attempts to answer this question. ⋯ We demonstrated an effect of remifentanil on both the middle latency auditory evoked response and haemodynamic changes to endotracheal intubation. For the non-intubated patients there was only an effect of remifentanil on the haemodynamic measurements. This suggests that remifentanil has an effect on the middle latency auditory evoked response in attenuating the arousal associated with intubation of the trachea but has no effect in the absence of a stimulus.
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Comparative Study
Comparative incidence of venous air embolism and associated hypotension in adults and children operated for neurosurgery in the sitting position.
Venous air embolism is a constant threat during neurosurgery performed in the sitting position. No large prospective study has compared the incidence of venous air embolism and associated hypotension between adults and children. ⋯ The incidence of venous air embolism and consequent hypotension is similar in adults and children.
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In this review paper, the authors critically analyse the use of a number of depth of anaesthesia monitors in light of the most recent literature and their own clinical experience. There appears to be increasing evidence that anaesthesia depth monitors reduce the incidence of unexpected intraoperative awareness and also that they improve the quality of anaesthesia. ⋯ The information provided by anaesthesia depth monitors is detailed and relationships with clinical practice are established to provide the reader with key features for optimal use of those monitors and correct interpretation of data. Practitioners and patient's knowledge and expectations regarding this matter, as well as the cost-benefit relationship are also discussed.