Anaesthesia and intensive care
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Anaesth Intensive Care · Feb 2001
Randomized Controlled Trial Clinical TrialThe use of thiopentone/propofol admixture for laryngeal mask airway insertion.
An admixture of thiopentone and propofol was evaluated against propofol for laryngeal mask airway (LMA) insertion. Eighty-one ASA 1 and 2 18- to 65-year-old patients, premedicated with 7.5 mg midazolam orally were assigned randomly to receive either propofol 1% or an admixture of thiopentone and propofol (1.25% and 0.5% respectively), both at a dose of 0.25 ml x kg(-1). Satisfactory conditions for insertion were achieved with the admixture, which was comparable to propofol (73% vs 85%, P>0.05). ⋯ We conclude that thiopentone/propofol admixture can be a suitable alternative to propofol for LMA insertion, producing less hypotension while allowing cost savings of up to 45%. An admixture of thiopentone and propofol (1.25% and 0.5% respectively) can produce suitable conditions compared to propofol 1%, for laryngeal mask insertion. In addition to cost containment, the admixture also produces less hypotension.
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Anaesth Intensive Care · Feb 2001
Randomized Controlled Trial Clinical TrialA randomized comparison of low-dose ketamine and lignocaine infiltration with ketamine-diazepam anaesthesia for post partum tubal ligation in Vanuatu.
Ketamine remains one of the most commonly used anaesthetic agents around the world. Despite it being the anaesthetic agent of choice in many developing nations, there is a paucity of literature describing ketamine in the developing world. In what we believe is the first randomized controlled trial to be performed in Vanuatu (formerly the New Hebrides) we compared the use of ketamine 0.9 mg/kg and diazepam 0.07 mg/kg with ketamine 0.3 mg/kg and 2% lignocaine infiltration in 50 Melanesian women undergoing post partum tubal ligation. ⋯ In institutions where post-anaesthesia care resources are limited, 0.3 mg/kg ketamine with local anaesthesia provides for earlier self-care of patients after tubal ligation, without compromise of analgesia, emergence or satisfaction. The implications of these findings extend to other procedures that require short general anaesthesia, which can be adequately performed with low-dose ketamine and local anaesthesia. The latter technique allows more rapid awakening.
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Anaesth Intensive Care · Feb 2001
A standardized, uniform and universal dental chart for documenting state of dentition before anaesthesia.
It is vital to have adequate and precise documentation of the condition of a patient's dentition before commencing an anaesthetic. The incidence of dental damage during anaesthesia is not low. To the authors' knowledge, there is no standardized method used by anaesthetists to document the state of a patient's dentition. ⋯ This vital information can be easily obtained during the preanaesthetic assessment. With the increase in medical litigation and demands for adequate documentation, we believe this chart can become an invaluable part of every hospital's preanaesthetic assessment form. The dental chart is to be offered as a service to anaesthetists in the form of a copyright-free "Freeware" computer diskette or adhesive sticker and will be downloadable from the internet.
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Anaesth Intensive Care · Feb 2001
Case ReportsPatient-controlled spinal analgesia for labour and caesarean delivery.
Continuous spinal anaesthesia has not been widely used in Australia. Epidural anaesthesia is often inadequate in patients with previous spinal surgery, as distribution of local anaesthetic in the epidural space is unpredictable. Two cases are presented where continuous spinal anaesthesia enabled satisfactory analgesia and anaesthesia to be obtained for labour and caesarean delivery respectively.
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Anaesth Intensive Care · Feb 2001
Case ReportsAnaesthetic management of a caesarean section in a patient with Marfan's syndrome and aortic dissection.
This report describes a case of a Stanford Type B aortic dissection (originating distal to the left subclavian artery and extending to the aortic bifurcation and proximal left iliac artery) in a 31-year-old primigravid woman who was at 39 weeks gestation and had Marfan's syndrome. The dissection was managed conservatively. ⋯ She was discharged from hospital two weeks after delivery and remained asymptomatic at six months. There are no plans for surgical intervention.