European journal of anaesthesiology
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Little information exists on cerebrospinal fluid pressures in non-labouring pregnant women. The technique of spinal anaesthesia means that inadequate levels of sensory blockade are difficult to manage. If the block is found to be inadequate after surgery has commenced, then conversion to general anaesthesia may be the only option. It is important that any manoeuvre altering the spread of local anaesthetic is considered at the time of subarachnoid injection. This study investigates the feasibility of using a fine bore needle with an electronic transducer to measure cerebrospinal fluid pressure and whether this was affected by either of the two lateral positions. We also sought to measure whether the right or left lateral position affected subsequent block height and requirements for supplementary analgesia. ⋯ Adoption of either the right or left lateral position for placement of spinal anaesthesia results in no difference in cerebrospinal fluid pressure or quality of block. The technique described gives a reliable and reproducible method of cerebrospinal fluid pressure measurement.
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It is claimed that local anaesthetics have antimicrobial properties. Our aim was to investigate the antimicrobial effects of different concentrations of ropivacaine, bupivacaine, lidocaine and prilocaine on Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans. ⋯ Ropivacaine had no antimicrobial effect on microorganisms tested. Bupivacaine showed poor antimicrobial effectiveness. Lidocaine and prilocaine had more powerful antimicrobial effects than the other two local anaesthetics.
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Randomized Controlled Trial Comparative Study Clinical Trial
The laryngeal mask and VBM laryngeal tube compared during spontaneous ventilation. A pilot study.
The laryngeal tube is a variant of the oesophageal obturator airway. The manufacturer claims that it is an alternative to ventilation with a facemask, laryngeal mask or endotracheal tube. To date, published studies have only involved controlled ventilation. We wished to find out if its use in spontaneous ventilation was equivalent to using the laryngeal mask airway. ⋯ We conclude that the laryngeal tube is not a satisfactory device for management of the airway during spontaneous ventilation.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Remifentanil and fentanyl during anaesthesia for major abdominal and gynaecological surgery. An open, comparative study of safety and efficacy.
and objective This open, multicentre study compared the efficacy and safety of remifentanil with fentanyl during balanced anaesthesia with 0.8% isoflurane (end-tidal concentration) for major abdominal and gynaecological surgery, and the efficacy and safety of remifentanil for pain management in the immediate postoperative period. ⋯ Anaesthesia combining isoflurane with a continuous infusion of remifentanil was significantly more effective than fentanyl at blunting responses to surgical stimuli. Significantly fewer patients responded to tracheal intubation with remifentanil at 0.4 microg kg(-1) min(-1), supporting the use of a higher initial infusion rate before intubation. Both remifentanil and fentanyl were well-tolerated, with reported adverse events typical of mu-opioid agonists.