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
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.
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Anaesth Intensive Care · Jan 2011
Randomized Controlled Trial Comparative StudyUltrasound-guided lateral femoral cutaneous nerve block: comparison of two techniques.
The aim of this study was to compare the feasibility and efficacy between two techniques of ultrasound-guided lateral femoral cutaneous nerve with or without locating the nerve. The study enrolled 106 patients undergoing knee surgery who received 5 ml of 1% mepivacaine immediately under the inguinal ligament 1 to 2 cm medial to the anterior superior iliac spine (subinguinal technique) or around the lateral femoral cutaneous nerve located (nerve-targeting technique). ⋯ However, a significantly higher percentage of patients obtained loss of pinprick sensation on the lateral thigh within 10 minutes with the subinguinal technique than with the nerve-targeting technique. The findings suggest that ultrasound-guided lateral femoral cutaneous nerve blocks can be easily performed and that injecting local anaesthetic immediately under the inguinal ligament rather than around the nerve itself blocks the nerve more reliably.
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Anaesth Intensive Care · Jan 2011
Randomized Controlled TrialThe effects of positive or negative words when assessing postoperative pain.
Negative or harsh words such as 'pain' and 'sting' used to describe sensations prior to potentially painful procedures have been shown to increase pain. We aimed to determine whether the reporting of pain and its severity is affected by the way it is assessed during anaesthesia follow-up after caesarean section. Following caesarean section, 232 women were randomised prior to post-anaesthesia review. ⋯ The assessment of pain after caesarean section, using more positive words, decreases its incidence but does not affect its severity when measured by pain scores. Words that focus the patient on pain during its assessment may lead some to interpret sensations as pain which they might not do otherwise. These findings may have important implications when assessing and researching postoperative pain.
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Anaesth Intensive Care · Jan 2011
Validation of the postoperative nausea and vomiting intensity score in gynaecological patients.
The Postoperative Nausea and Vomiting (PONV) Intensity Scale was developed to distinguish trivial from clinically important PONV perioperatively and has been validated in a general surgical population. This study aimed to assess the scale in gynaecological surgery patients. Seventy-three patients undergoing gynaecological surgery were included. ⋯ The median nausea visual analogue scale scores at four hours were 69 mm (interquartile range 69 to 76 mm) in patients with a clinically significant score vs 0 mm (0 to 9 mm) in patients without a clinically significant score (mean difference 56 mm, 95% confidence interval 41 to 72 mm, P < 0.0001). The PONV Intensity Scale is a valid, responsive and practically useful instrument in distinguishing trivial from clinically significant PON. The rate of clinically important PONV is considerably lower than the rate of any PONV symptoms perioperatively.