Anaesthesia and intensive care
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Anaesth Intensive Care · Jan 2011
Randomized Controlled TrialEffect of intravenous ondansetron on sensory and motor block after spinal anaesthesia with hyperbaric bupivacaine.
Ondansetron is a potent antiemetic and a competitive antagonist at serotonin receptors, which are also involved in modulation of pain. This study was designed to assess the effect of systemic ondansetron on sensory and motor block after subarachnoid anaesthesia with hyperbaric bupivacaine. Sixty patients undergoing transurethral resection of bladder tumours were randomly assigned to one of two groups. ⋯ No differences in regression of sensory block were noted at any time. The mean duration of motor block also did not differ (P = 0.44), with similar regression of block at all time intervals except at 90 minutes. We concluded that intravenous ondansetron does not affect the intensity or duration of sensory and motor block after spinal anaesthesia with hyperbaric bupivacaine.
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Anaesth Intensive Care · Jan 2011
Long-term follow-up of patients with post-traumatic refractory high intracranial pressure treated with lumbar drainage.
Drainage of cerebrospinal fluid by means of external lumbar drainage (ELD) is controversial in the adult population with traumatic brain injury. We report our experience with ELD in the treatment of post-traumatic high intracranial pressure (ICP) and the results of the long-term follow-up in these patients. We undertook clinical evaluation of 30 patients with traumatic brain injury and high ICP treated with second-tier measures or with first-tier measures if second-tier measures were contraindicated. ⋯ Long-term outcome was favourable (good recovery or moderate disability) in 62% of the patients studied. The use of ELD resulted in a marked decrease in ICP These patients presented a good outcome in 62% of the cases in the long-term evaluation. Few complications related with ELD use were noted.
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There is little information about analgesia use or pain experienced in children after neurosurgery. The aims of this study were to assess the degree of pain experienced by children after neurosurgery and the analgesic regimens used, and to identify factors associated with significant pain. Data for 52 children who underwent craniotomy were collected contemporaneously over 72 hours. ⋯ Using multivariate regression, duration of procedure was the only factor associated with parenteral morphine use for > 24 hours, and older age was the only factor associated with having an episode of pain scoring > 3. No episodes of significant respiratory depression were noted. At our institution, children receive multimodal analgesia after neurosurgery, commonly parenteral morphine, and this is usually associated with low pain scores.
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Anaesth Intensive Care · Jan 2011
Letter Case ReportsThe i-gel in failed obstetric tracheal intubation.
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Anaesth Intensive Care · Jan 2011
ReviewImpact of assessments on learning and quality of life during anaesthesia training in Australia and New Zealand.
Assessments are a major factor in the life of anaesthesia trainees, and the impact of assessments on learning is widely acknowledged. Assessment format can have a significant impact on how trainees learn and the extent to which they reach the goals of the curriculum. The assessment format can affect approaches to learning, encouraging surface, deep or strategic learning. ⋯ Specialist examinations are stressful and examination preparation has a major impact on lifestyle, stress and burnout, which have been identified as major concerns in doctors. The additional burden of assessments may contribute. A better understanding of the impact of assessments on both learning and quality of life is required to better inform decisions on future directions in anaesthesia training in Australia and New Zealand.