Anaesthesia and intensive care
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Anaesth Intensive Care · Dec 1996
Randomized Controlled Trial Comparative Study Clinical TrialA prospective clinical comparison of two intravenous polyurethane cannulae.
Tissue irritation, as evidenced by phlebitis, associated with Optiva (Johnson & Johnson Medical) and Insyte (Becton Dickinson) polyurethane cannulae was studied. The integrity of the cannulae on removal, the incidence of infection at the cannula site and the factors which influence phlebitis were also examined. One thousand and eight patients had a polyurethane cannula placed for induction of anaesthesia for cardiac surgery. ⋯ Minor tip distortion or shaft kinking of the cannulae occurred in 16.2% of Optiva and 23.5% of Insyte. This difference is statistically significant and may relate to the slightly more acute taper at the Optiva cannula tip. Both cannulae were similar in clinical performance.
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Anaesth Intensive Care · Dec 1996
Randomized Controlled Trial Clinical TrialAnalgesic efficacy of paracetamol in children using tonsillectomy as a pain model.
The analgesic efficacy of paracetamol was assessed in a prospective, randomized, double-blinded study of 100 children undergoing tonsillectomy with or without adenoidectomy. Fifty children were given paracetamol elixir 40 mg/kg 40 minutes preoperatively (Group A); the remaining 50 children were given an oral placebo 40 minutes preoperatively and paracetamol suppositories 40 mg/kg after induction of anaesthesia (Group B). Paracetamol was the only analgesic given and was given either orally or rectally in order to produce high variations in plasma paracetamol concentrations postoperatively. ⋯ The incidence of nausea and vomiting was the same in both groups (20%) during the 24 hour postoperative period. Plasma paracetamol concentrations of 0.066-0.132 mmol/l are known to reduce temperature; plasma paracetamol concentrations which provide analgesia are unknown. Children with plasma paracetamol concentrations above 0.07 mmol/l had superior analgesia to those with concentrations below this level (P < 0.05).
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We have identified some of the most frequently measured anaesthetic outcomes and their independent risk factors, and discussed the limitations and advantages in using various risk adjustment strategies. Many studies suggest that preoperative assessments may contribute to preventing the occurrence of anaesthetic-related morbidity and mortality, and to high levels of patient satisfaction. The use of health status measurements as a preoperative screening tool in assessing anaesthetic risk offers a potential area for future work. Research into measuring anaesthetic outcomes in a reliable and valid manner will be an important tool in improving standards of anaesthetic practice and in delivering quality anaesthesia to our patients.