Anaesthesia and intensive care
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Anaesth Intensive Care · Oct 2001
Randomized Controlled Trial Clinical TrialChange in endotracheal tube cuff pressure during nitrous oxide anaesthesia: a comparison between air and distilled water cuff inflation.
In this prospective, randomized controlled trial, changes in endotracheal tube cuff pressure were studied in 60 patients undergoing elective surgery under general anaesthesia with nitrous oxide and oxygen. The cuffs were inflated with either air or distilled water. ⋯ The pressure and the rate of rise in cuff pressure were significantly lower (P<0.05) in the water-filled cuffs throughout the hour of study. When an endotracheal tube cuff is distended with water, the rise in cuff pressure during nitrous oxide anaesthesia is lower than that of an air-filled cuff.
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Anaesth Intensive Care · Oct 2001
Randomized Controlled Trial Clinical TrialHypotension in elderly patients undergoing spinal anaesthesia for repair of fractured neck of femur. A comparison of two different spinal solutions.
Intraoperative hypotension is a common and sometimes deleterious event in elderly patients undergoing spinal anaesthesia for repair of hip fractures. The synergism between intrathecal opioids and local anaesthetics may allow a reduction in the dose of local anaesthetic and reduce hypotension, while still maintaining adequate anaesthesia. We studied 42 elderly patients having insertion of a Richards pin and plate and compared 7.5 mg hyperbanic bupivacaine with added fentanyl 20 microg (group BF) to 12.5 mg hyperbaric bupivacaine alone (group B). ⋯ There was no difference in the incidence or severity of hypotension between the two groups. Two patients from group B and one from group BF experienced mild discomfort. Pruritus was more common in group BF.
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Anaesth Intensive Care · Oct 2001
Multicenter StudyThe frequency and nature of drug administration error during anaesthesia.
We aimed to establish the frequency and nature of drug administration error in anaesthesia (a significant subset of error in medicine) at two hospitals. Anaesthetists were asked to return a study form anonymouslyfor every anaesthetic, indicating whether or not a drug administration error or pre-error (defined as any incident with potential to become an error) had occurred. Further details were sought if the response was affirmative. ⋯ One patient was aware while under muscle relaxation, and two required prolonged ventilation. In addition, 47 transient physiological effects were reported, of which five required intervention. We conclude that drug administration error during anaesthesia is considerably more frequent than previously reported.
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Anaesth Intensive Care · Oct 2001
Randomized Controlled Trial Clinical TrialEffect of age on recovery from remifentanil anaesthesia.
In a prospective, randomized study, the effect of age on recovery from remifentanil anaesthesia was evaluated. Twenty consecutive patients classified as ASA 1 and 2 and having elective laparotomy were recruited to one of two groups based on age (Group 1 age <60 y and Group 2 age >60 y). Remifentanil boluses and infusion were used for induction and maintenance of anaesthesia. ⋯ A P value <0.05 was taken as significant. We found that the younger age group regained spontaneous respiration (0.8+/-0.7 min vs 3.2+/-3.6 min), adequate respiration (3.4+/-3.7 min vs 7.6+/-5.8 min), opened their eyes (0.9+/-1.0 min vs 3.6+/-4.4 min), had their endotracheal tubes removed (5.0+/-4.6 min vs 9.0+/-6.5 min) and were discharged to recovery room (8.8+/-4.3 min vs 14.5+/-7.1 min) earlier than their older counterparts. In conclusion, age was a co-variate for recovery from remifentanil anaesthesia.
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Anaesth Intensive Care · Oct 2001
Randomized Controlled Trial Clinical TrialLaryngeal mask airway insertion in paediatric anaesthesia: comparison between the reverse and standard techniques.
Sixty-seven children between one and 15 years of age were randomized to have Laryngeal Mask Airway (LMA) insertion using either the standard technique (Group A) as described by Brain or the "reverse technique" (involving a 180 degree turn after insertion with the cuff facing the palate) (Group B). A blinded observer using a fibreoptic bronchoscope assessed the final position of the LMA. ⋯ The 95% confidence interval for the difference in success rates between Group B and A (B-A) was -0.73% to 20.1%. It is our opinion that the reverse technique of insertion of the LMA is an acceptable alternative to the standard technique.