Anaesthesia and intensive care
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Anaesth Intensive Care · Jun 1999
Randomized Controlled Trial Clinical TrialComparison of 1% ropivacaine and a mixture of 2% lignocaine and 0.5% bupivacaine for peribulbar anaesthesia in cataract surgery.
The purpose of the study was to compare 1% ropivacaine and hyaluronidase 75 units/ml with a 1:1 mixture of 2% lignocaine and 0.5% bupivacaine and hyaluronidase 75 units/ml for peribulbar anaesthesia in cataract surgery. We conducted a double-blind randomized trial involving 100 patients. Group 1 received a peribulbar injection of 8 ml of 1% ropivacaine and hyaluronidase 75 units/ml. ⋯ No statistical differences were found between the two groups regarding any of the study parameters. Both groups had excellent surgical analgesia and akinesia. We conclude that 1% ropivacaine is a suitable agent for single injection peribulbar anaesthesia for cataract surgery.
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Anaesth Intensive Care · Jun 1999
Randomized Controlled Trial Clinical TrialDoes local anaesthetic affect the success rate of intravenous cannulation?
We aimed to assess whether subcutaneous lignocaine affects the success rate of intravenous cannulation using a randomized clinical trial. Pre-prepared cannulation packs, 50% containing local anaesthetic, were used to cannulate consecutive consenting patients presenting to the Emergency Department who required cannulation as part of their routine treatment. Doctors with less than four years postgraduate experience randomly selected a pack to perform cannulation and completed a data collection form after each cannulation. ⋯ Subcutaneous lignocaine did not significantly affect the success rate of intravenous cannulation on the first attempt (P = 0.5). Subcutaneous lignocaine has been shown to significantly reduce the pain of intravenous cannulation. This study supports the use of local anaesthesia for all routine venous cannulation.
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Anaesth Intensive Care · Jun 1999
Case ReportsBilevel non-invasive ventilation in malignant large airways obstruction during chemotherapy and radiotherapy.
A case is described of acute respiratory failure secondary to variable intrathoracic large airway obstruction due to a lung neoplasm. Successful ventilation was achieved with facemask bilevel non-invasive ventilatory assistance allowing radiotherapy and chemotherapy to be undertaken.
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Anaesth Intensive Care · Jun 1999
Case ReportsRecent experiences with hexadimethrine for neutralizing heparin after cardiopulmonary bypass.
Hexadimethrine bromide was used for the neutralization of heparin during cardiac surgery in the late 1950s. For some years, this institution has used it for patients who may be allergic to protamine. In view of the recent renewal of interest in hexadimethrine, we present four cases outlining its use during cardiac procedures in such patients. Other drugs for reversing the action of heparin such as heparinase or platelet factor IV are not yet widely available.
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Anaesth Intensive Care · Jun 1999
Incidents in obstetric anaesthesia and analgesia: an analysis of 5000 AIMS reports.
We aimed to explore the first 5000 incidents reported to the Australian Incident Monitoring Study (AIMS) involving anaesthesia for obstetric patients and found 203 such incidents. Analysis and classification identified seven main incident groups; regional anaesthetic techniques (33%), anaesthetic equipment problems (13%), "wrong drug" errors (10%), other drug-related problems (16%), difficult/failed intubation (9%), problems with the endotracheal tube (9%) and other problems (10%). When compared to the incidents in the main database, obstetric cases were found to be over-represented with respect to accidental dural puncture, post dural puncture headache, failed intubation in emergency situations and the incidence of certain types of "wrong drug" error. The implications of these reports regarding safe practice of obstetric anaesthesia are discussed.