Anaesthesia and intensive care
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Anaesth Intensive Care · Jun 2004
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialIntraoperative patient warming using radiant warming or forced-air warming during long operations.
Forced-air warming is the most commonly used and effective method of active warming. A new radiant warming device (Suntouch, Fisher and Paykel) may provide an alternative when the skin surface available for warming is limited. We conducted a randomized controlled trial to compare the efficacy of the Suntouch radiant warmer and forced-air warming. ⋯ No other patient variables were significantly different. The Suntouch is not as effective as the forced air warming for intraoperative warming during long surgical procedures. The device may be useful when forced-air warming is not possible.
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Anaesth Intensive Care · Jun 2004
Randomized Controlled Trial Comparative Study Clinical TrialThe differential flow of epidural local anaesthetic via needle or catheter: a prospective randomized double-blind study.
The extent of epidural anaesthesia and pattern of spread of contrast medium, using different injection techniques, has not been well documented. Therefore, in this prospective, randomized double-blind study, the extent of anaesthesia and pattern of spread of contrast medium following an epidural bolus injection, via either a Tuohy needle or an epidural catheter, were compared. The study had two parts. ⋯ No differences were found in the extent of sensory anaesthesia or the spread of contrast medium. Twenty per cent of catheter tips lay outside the lateral margins of the vertebral bodies. We found that an epidural bolus injection, via either a Tuohy needle or a catheter, made no difference in regard to spread of local anaesthetic or contrast medium in the epidural space.
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Anaesth Intensive Care · Jun 2004
Randomized Controlled Trial Comparative Study Clinical TrialCrystalloid preload versus rapid crystalloid administration after induction of spinal anaesthesia (coload) for elective caesarean section.
Current methods of crystalloid preload administration prior to spinal anaesthesia for elective caesarean section are relatively ineffective in preventing hypotension. This study examined the relevance of the timing of the fluid administered. Fifty women were randomly allocated to receive either 20 ml x kg(-1) of crystalloid solution during 20 minutes prior to induction of spinal anaesthesia (preload), or an equivalent volume by rapid infusion immediately after induction (coload). ⋯ There was no between-group difference in either the total cumulative dose, or in the total number of doses of ephedrine. Neonatal outcomes among the two groups were similar. Rapid crystalloid administration after, rather than over 20 minutes before the induction of spinal anaesthesia for elective caesarean section, may be advantageous in terms of managing maternal blood pressure prior to delivery.
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Anaesth Intensive Care · Jun 2004
Randomized Controlled Trial Comparative Study Clinical TrialComparison of laryngeal mask airway with tracheal tube for ophthalmic surgery in paediatric patients.
This study of sixty ASA grade 1 or 2 children, aged 1 to 12 years, undergoing elective ophthalmic procedures, compared the use of the laryngeal mask airway (LMA) with that of an endotracheal tube. Changes in intraocular pressure and haemodynamic parameters, and intraoperative and postoperative complications were measured Patients were randomly allocated into two groups of 30 patients. In group 1, the airway was secured with an LMA and in group 2 with an endotracheal tube. ⋯ The incidence of postoperative coughing was lower in the LMA group, but the incidence of vomiting higher. Two patients had displacement of the LMA during the procedure. We conclude that the use of an LMA is associated with less increase in intraocular pressure than the use of an endotracheal tube in children.