Anaesthesia and intensive care
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Anaesth Intensive Care · Jul 2015
Randomized Controlled Trial Comparative StudySpinal anaesthesia with adjunctive intrathecal morphine versus continuous lumbar plexus blockade: a randomised comparison for analgesia after hip replacement.
Following elective total hip replacement, both continuous lumbar plexus blockade and spinal anaesthesia (with adjunctive intrathecal morphine) have shown early outcome benefits over opioid analgesia and single-injection nerve block. However, the two techniques have not been compared in a prospective randomised manner. Our study examined 50 patients undergoing elective hip joint replacement who were randomised to receive spinal anaesthesia (with adjunctive intrathecal morphine 0.1 mg) or patient-controlled continuous lumbar plexus blockade. ⋯ Postoperative symptoms suggestive of neurological irritation or injury did not differ between groups. We found that following elective hip joint replacement, compared to continuous lumbar plexus blockade, spinal anaesthesia incorporating adjunctive intrathecal morphine did not result in a statistically significant difference in worst pain on movement/mobilisation during the first 24 hours, although it was associated with better analgesia in the post-anaesthesia care unit. Subsequently, however, these patients appeared to require more rescue morphine and more of them reported pruritus.
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Anaesth Intensive Care · Jul 2015
Historical ArticlePioneers of laryngoscopy: indirect, direct and video laryngoscopy.
Airway management is one of the core skills of the anaesthetist and various techniques of airway management have developed over many years. Initially, the only view of the glottis that could be obtained was an indirect view (indirect laryngoscopy). ⋯ Currently, in the early 21st century, there has been a return to indirect laryngoscopy via videolaryngoscopy using a videolaryngoscope. The aim of this paper is to give a historical overview of the development of both direct and indirect laryngoscopy.
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Anaesth Intensive Care · Jul 2015
Historical ArticleThe evolution of the polyvinyl chloride endotracheal tube.
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Anaesth Intensive Care · Jul 2015
An audit of the haemodynamic and emergence characteristics of single-shot 'ketofol'.
A small audit showing the acceptability and absence of significant side effects of ketofol when used for brief procedural sedation (tubal ligation), particularly in the low resource setting.
Patients received a premixed ketofol dose of 0.5 mg/kg ketamine and 0.9 mg/kg propofol after fentanyl 1 mcg/kg.
Notably there was universal hemodynamic stability, although almost half of the audited patients required airway support.
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