Anaesthesia and intensive care
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Anaesth Intensive Care · Nov 2009
ReviewThe efficacy of landiolol for suppressing the hyperdynamic response following laryngoscopy and tracheal intubation: a systematic review.
Landiolol is a recently developed, selective short-acting beta1-antagonist. The aim of the study was to evaluate the efficacy of landiolol for suppressing haemodynamic changes induced by laryngoscopy and tracheal intubation (LTI) in Japanese patients. A comprehensive search was undertaken to identify all randomised comparisons of landiolol with placebo that examined effects on haemodynamic responses following LTI. ⋯ The other two studies used bolus administration of landiolol (0.1 to 0.3 mg/kg), but it was difficult to evaluate the efficacy because of the limited amount of data. Landiolol administration at 0.125 mg/kg/minute for one minute followed by 0.04 mg/kg/minute effectively suppresses the increases in heart rate and blood pressure following LTI. For a bolus regimen of landiolol, further studies are required to determine the efficacy and the optimal dose and timing for suppression of haemodynamic responses following LTI.
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Anaesth Intensive Care · Nov 2009
ReviewThe rise of simulation in technical skills teaching and the implications for training novices in anaesthesia.
Changes in work practices have led to a decline in the opportunities for anaesthetic trainees to learn technical procedures in supervised practice. Efforts to mitigate medical error and other changes have coincided with the development of alternative training methods so that it is increasingly difficult to justify the traditional model of teaching technical procedures. The range of simulators available for training in technical procedures in anaesthesia continues to expand. ⋯ Using the available simulation equipment and educational tools, trainees can be prepared to begin supervised practice having demonstrated adequate procedural knowledge and expertise in simulation. With the use of simulated patients there is also the opportunity to integrate non-technical skills as well where appropriate. This review summarises the justification for the use of simulation in technical skills training in anaesthesia and the educational theory that supports its use, and outlines one of the available frameworks that can be used to aid its application.