European journal of anaesthesiology
-
Randomized Controlled Trial Comparative Study Clinical Trial
Light-guided tracheal intubation using a prototype illuminated flexible catheter through the intubating laryngeal mask.
We evaluated the efficacy of a newly developed prototype illuminated flexible catheter to facilitate tracheal intubation through the intubating laryngeal mask and compared this light-guided technique with the conventional blind tracheal intubation through the intubating laryngeal mask. The illuminated flexible catheter consists of a completely flexible thin plastic catheter, a bulb attached to its distal end, a 15-mm concentric adapter at its proximal end connected with a battery and a power switch. The device is placed into a silicone tracheal tube in such a way that the bulb protrudes from the distal end of the tracheal tube. ⋯ The success rate for the blind and light-guided technique was 91% and 100%, respectively (P = 0.003). The mean (+/- SD) duration including appropriate intubating laryngeal mask placement and tracheal intubation, was significantly lower in the light-guided tracheal intubation technique, than with the blind tracheal intubation (31 +/- 8 s vs. 43 +/- 18 s; P < 0.0001). We conclude that the use of an illuminated flexible catheter carries advantages either in optimizing the intubating laryngeal mask position in the laryngopharynx or in achieving a quick and safe light-guided advancement from laryngopharynx into the trachea.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Oral tramadol: analgesic efficacy in children following multiple dental extractions.
In a randomized double-blind study, 60 children, aged 4-7 years, undergoing dental extractions of six or more teeth under day-case general anaesthesia, were assigned to receive either tramadol drops 1.5 mg kg-1 (n = 31), or placebo (normal saline) (n = 29), 30 min before surgery. In addition, all received anxiolytic pre-medication of oral midazolam 0.5 mg kg-1 (max 7.5 mg) at the same time. No differences were seen in behaviour, respiratory or cardiovascular assessments. ⋯ Analysis of the Oucher six faces pain scale showed significantly better analgesia in the tramadol group at all time points, the pain score being half that of the placebo group at 60 min and one third from 60 to 120 min (P < 0.05). No adverse respiratory or cardiovascular effects were seen. For children undergoing multiple extractions, 10.7, SD 3.0, effective postextraction analgesia was provided.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Continuous spinal anaesthesia or continuous epidural anaesthesia for post-operative pain control after hip replacement?
Both continuous spinal anaesthesia and continuous epidural anaesthesia are supposed to provide adequate post-operative pain relief. The purpose of this randomized, prospective study was to compare the quality of analgesia, occurrence of side effects and patient satisfaction between spinal and epidural administration of bupivacaine during the first post-operative 72 h. One hundred and two patients scheduled for hip arthroplasty were randomly assigned to one of two groups: Group 1 received continuous spinal anaesthesia for intra-operative and post-operative management, Group 2 received continuous epidural anaesthesia. ⋯ The satisfaction was considered excellent in 92.2% of the continuous spinal anaesthesia-group and in 70.6% of the continuous epidural anaesthesia-group. It is concluded that continuous spinal anaesthesia and continuous epidural anaesthesia are effective and safe for post-operative pain relief after hip replacement. Compared with continuous epidural anaesthesia, continuous spinal anaesthesia provides faster onset of pain relief, ensures better analgesia and results in more satisfied patients.
-
Concerns about life support equipment accompanying the critically ill patient have to date made magnetic resonance imaging (MRI) studies of this patient group the exception. We present here a series of tests performed on an IVAC P3000 infusion pump to investigate its suitability for the magnetic resonance imaging environment. ⋯ Gravimetric tests found the pump to work within acceptable parameters at a static field of 10 mT. Image interference issues were addressed.