Anaesthesia and intensive care
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Anaesth Intensive Care · Feb 2004
Evaluation of the Intubating Laryngeal Mask Airway used by occasional intubators in simulated trauma.
This observational study assessed the potential role of the intubating laryngeal mask airway (ILMA) for use by emergency care givers with limited laryngoscopy skills. Six ambulance officers with advanced airway training, five doctors with intubation experience and five doctors without intubation experience were given a short instruction course on the use of the ILMA. They subsequently used the device on 80 consenting subjects anaesthetized for elective surgery after the application of cricoid pressure and manual in-line stabilization of the cervical spine. ⋯ The feedback forms were strongly supportive of a prehospital trial and also of having an ILMA available during all intubations. Participants almost universally rated the ILMA as easy to use. This study supports further evaluation of the ILMA in a large prehospital trial.
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This is a preliminary report on the use of the modified Airway Management Device in 50 spontaneously breathing patients undergoing elective day care surgery. We were successful in establishing a clear airway in all 50 patients, 46 of these patients had a patient airway on the first attempt. ⋯ Partial airway obstruction during maintenance of anaesthesia occurred in three cases requiring only minor manipulations. Our result showed that the Airway Management Device may be used as an alternative airway management in anaesthesia.
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Anaesth Intensive Care · Feb 2004
Historical ArticleLocal anaesthesia--the continuing evolution of spinal needles.
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Anaesth Intensive Care · Feb 2004
Letter Case ReportsBreathing circuit obstruction by a foreign body.
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Anaesth Intensive Care · Feb 2004
ReviewSpinal cord stimulation in chronic pain: a review of the evidence.
This review looks at the evidence for the effectiveness of spinal cord stimulation in various chronic pain states. Spinal cord stimulation can only be effective when appropriate dorsal column fibres in the spinal cord are preserved and able to be stimulated. Spinal cord stimulation has been shown to have little to offer for patients with some diagnoses. ⋯ There is a lack of high quality evidence relating to spinal cord stimulation due to difficulties in conducting randomized controlled trials in this area. Serious methodological problems are encountered in blinding, recruitment and assessment in nearly all published trials of spinal cord stimulation. Suggestions regarding appropriate methodologies for trials which would produce better quality evidence are summarized.