European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Post-operative analgesia following femoral-neck surgery--a comparison between 3 in 1 femoral nerve block and lateral cutaneous nerve block.
A prospective controlled randomized trial on patients receiving surgery for fractured neck of femur was carried out, in which post-operative analgesic requirements in three separate groups were compared. Patients in Group 1 acted as controls, whilst those in Groups 2 and 3 received lateral cutaneous nerve blocks and 3 in 1 femoral nerve blocks, respectively. Patients in Group 3 needed significantly less analgesia than the other two groups, and the time to first administration of analgesia was significantly longer. No complications of either of the nerve blocks was noted.
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Transfusion in the exsanguinating Jehovah's Witness patient--the attitude of intensive-care doctors.
The attitude of a Jehovah's Witness patient refusing a blood transfusion during an exsanguinating episode can raise important ethical problems. Various ethical principles, including the patient's autonomy, the sanctity of life and the dignity of the medical profession can be confronted. A total of 242 doctors, members of the European Society of Intensive Care Medicine, answered a questionnaire indicating that 63% would transfuse in those circumstances. ⋯ Only 45% considered the blood transfusion as appropriate, of whom 25% were unable to define the best option. Doctors from France and Italy more commonly transfuse while those from The Netherlands, the United Kingdom and Scandinavia more commonly withhold transfusion. These data stress the need for a definition of the appropriate medical attitudes towards the patient refusing blood transfusion.
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Randomized Controlled Trial Clinical Trial
Awakening and recovery of simple cognitive and psychomotor functions 2 h after anaesthesia for day-case surgery--total intravenous anaesthesia with propofol-alfentanil versus thiopentone-alfentanil.
Fifty-seven patients undergoing minor out-patient gynaecological procedures were allocated to one of two total intravenous anaesthesia regimes: propofol and alfentanil or thiopentone and alfentanil. Diazepam was given orally as premedication. ⋯ The time to opening of eyes and orientation was equal in both groups, as was the recovery of the tested cognitive and psychomotor functions after 2 h, when the score in both groups had returned to baseline. We conclude that the use of propofol instead of thiopentone for shorter surgical procedures gives no advantage as regards length of stay in hospital.
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Randomized Controlled Trial Clinical Trial
Is the diagnosis of significant residual neuromuscular blockade improved by using double-burst nerve stimulation?
Although DBS is more sensitive than TOFC, manual assessment of DBS fade can only detect residual paralysis at TOF ratio < 0.7.
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