European journal of anaesthesiology
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Operating room management structures and interrelationships both within the operating suite and with other departments in the hospital can be very complex. Several different professional and support groups are represented that often have infrastructures of their own that may compete or conflict with the management hierarchy in the operating room. Today, there is often little actual management of the operating suite as an entity. We surveyed current operating room management in Switzerland. ⋯ Current management of the operating room in Switzerland is far from best-practice standards.
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Patients receiving anticoagulants offer a challenge to anaesthesiologists. The issue of spinal haematoma following central neuraxial block in such patients is a contentious issue. Although rare, with an estimated incidence of < 1:150,000 for epidural blocks and 1:220,000 for spinal anaesthetics in patients with normal coagulation status, this is an emergency situation with a potentially grave prognosis. ⋯ Of the 60 cases reported in the literature, 33% occurred following central neuraxial block and, of these, 55% were associated with concomitant use of anticoagulants. The pharmacology of the newer and older anticoagulants is also described. The variety of risk factors and diverse recommendations that have been described in these patients are reviewed.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intravenous single-dose tramadol versus meperidine for pain relief in renal colic.
Comparison of the effectiveness of tramadol with meperidine given intravenously to emergency patients with suspected renal colic. ⋯ Meperidine 50 mg was superior to tramadol 50 mg for acute pain relief in patients with suspected renal colic when given intravenously. Because many patients in both groups received supplemental meperidine and the response to tramadol alone cannot be predicted, clinicians may want to choose higher doses of meperidine alone or other alternative combinations.
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Randomized Controlled Trial Comparative Study Clinical Trial
Conditions for insertion of the laryngeal mask airway: comparisons between sevoflurane and propofol using fentanyl as a co-induction agent. A pilot study.
To compare the conditions for insertion of the laryngeal mask airway using sevoflurane or propofol plus fentanyl. We evaluated the haemodynamic changes and cost of induction of anaesthesia in both groups. ⋯ Although there was a faster induction with propofol-fentanyl, conditions for insertion of the laryngeal mask airway were similar in both groups. Haemodynamic stability was better with sevoflurane-fentanyl. The propofol-fentanyl combination was more cost-effective.
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We measured the physical performance error of commercial syringe pumps incorporating the Diprifusor module to deliver propofol by target-controlled infusion in a laboratory experiment. ⋯ Despite the differences between the pumps, which may be related to the synchronization of the hardware components, the absolute inaccuracies in the physical performance were low and presumably negligible from a clinical point of view.