Anaesthesia and intensive care
-
Anaesth Intensive Care · Feb 2004
Historical ArticleLocal anaesthesia--the continuing evolution of spinal needles.
-
Anaesth Intensive Care · Dec 2003
Randomized Controlled Trial Clinical TrialCombination of adenosine with prilocaine and lignocaine for brachial plexus block does not prolong postoperative analgesia.
Adenosine analogues have been used by subarachnoid injection for the treatment of inflammatory and neuropathic pain. There is no data on the use of adenosine in peripheral nerve blocks. The aim of the present study was to determine the analgesic efficacy of adenosine in combination with a local anaesthetic solution for brachial plexus (BP) block. ⋯ Time to first pain sensation from block was not significantly longer in the adenosine group (379 +/- 336 min) compared with controls (304 +/- 249 min, mean +/- SD, P = 0.14). Time to first analgesic requirements and analgesic consumption in the first 24 hours were also similar in both study groups. In the present study, the addition of adenosine to local anaesthetic in brachial plexus block did not significantly extend the duration of analgesia.
-
Anaesth Intensive Care · Dec 2003
Randomized Controlled Trial Clinical TrialLevobupivacaine versus racemic bupivacaine in spinal anaesthesia for urological surgery.
Racemic bupivacaine is the most common local anaesthetic used intrathecally. This prospective, randomized, double-blind study compared the clinical efficacy and motor block of 0.5% levobupivacaine with 0.5% racemic bupivacaine in spinal anaesthesia for urological surgery. The surgery required an upper level of sensory block of at least the tenth thoracic dermatome. ⋯ There were no significant differences between the two groups in the quality of sensory and motor block or in haemodynamic change. Anaesthesia was adequate and patient satisfaction good in all cases. We conclude that 0.5% levobupivacaine can be used as an alternative to 0.5% racemic bupivacaine in spinal anaesthesia for surgery when a sensory block to at least T10 is required.
-
Anaesth Intensive Care · Dec 2003
Randomized Controlled Trial Clinical TrialThe influence of a blood conserving device on anaemia in intensive care patients.
The contribution of iatrogenic blood loss through diagnostic testing to the anaemia of critical illness remains controversial. We measured the effect of an arterial line blood conservation device upon blood loss and anaemia in adult intensive care patients. This randomized controlled trial of 160 patients in a major Intensive Care Unit (ICU) compared a blood conservation device (Venous Arterial Blood Management Protection Plus, VAMP Plus system, Baxter Healthcare) (VAMP group) to a standard arterial pressure line set attached to an arterial catheter (control group). ⋯ Both groups had a similar (median [range]) change in Hb during ICU admission (VAMP-7 [-84 to +21] g/l; Control -4 [-67 to +40] g/l; P = 0.33). The VAMP patients lost significantly less blood for diagnostic testing while in ICU (VAMP 63 [0 to 787] ml; Control 133 [7 to 1227] ml; P = 0.001). We conclude that the VAMP Plus system significantly reduced iatrogenic blood loss in critically ill patients, but this reduction did not affect the fall in Hb that accompanies critical illness.
-
Anaesth Intensive Care · Dec 2003
Decontamination issues and perceived reliability of the laryngoscope--a clinician's perspective.
The laryngoscope is identified as a potential vector for cross-infection. Case reports are presented, as are reports of bacterial and occult blood contamination of laryngoscope blades and handles. ⋯ Repeated decontamination of laryngoscope blades has resulted in a perceived decrease in reliability. This is reflected in a departmental survey where 86% of respondents consider the standard laryngoscope is only intermittently reliable and that there is room for improvement.