Anaesthesia and intensive care
-
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.
-
Anaesth Intensive Care · Oct 2001
Case ReportsA spoonful of sugar--improving the sensitivity of the glucose oxidase test strip method for detecting subclinical pulmonary aspiration of enteral feed.
A 74-year-old woman was admitted to the intensive care unit (ICU) with respiratory failure. Following intubation and mechanical ventilation, nasogastric enteral feeding was begun. The sensitivity of the glucose oxidase strip method for detecting aspiration of enteral feed has been questioned because the glucose levels in commonly used feeds are similar to those of normal tracheal aspirates. ⋯ Testing oral and tracheal secretions with standard glucose oxidase strips allowed the accurate detection of both pharyngeal regurgitation and tracheal aspiration. An episode of subclinical aspiration was detected and this was associated with a fall in the PaO2/FiO2 ratio. There were no further episodes of aspiration following the introduction of a gastric motility agent, maintaining the patient in the semi-recumbent position and an increase in the positive end expiratory pressure (PEEP).
-
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.
-
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.