Anaesthesia and intensive care
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Anaesth Intensive Care · Aug 1996
Audit of unbooked paediatric post-anaesthesia admissions to intensive care.
We performed an audit of booked and unbooked admissions to a paediatric intensive care unit (PICU) after anaesthesia over a 19 month period in order to determine whether unbooked admissions were predictable, or whether there were any preventable anaesthetic factors responsible for PICU admission, and to evaluate the necessity of PICU admission in all study patients. Data was collected from the PICU database and from the medical records, especially the anaesthesia records, of unbooked admissions. ⋯ There was an appropriate use of intensive care resources by these unbooked patients, with 77% having PICU-specific therapies (compared with 88% of booked cases). This quality assurance tool was relatively easy to perform, however it has numerous limitations hampering future routine use.
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Anaesth Intensive Care · Jun 1996
Randomized Controlled Trial Comparative Study Clinical TrialThe application of EMLA and glyceryl trinitrate ointment prior to venepuncture.
The efficacy of EMLA cream combined with glyceryl trinitrate (GTN) ointment was assessed by a double-blind prospective study. Adult female patients were randomly allocated to receive either EMLA 1 ml or 2 ml combined with GTN 2 mg, or EMLA 2 ml only. ⋯ There were no significant side-effects. It is concluded that if GTN is used with EMLA, the dose of EMLA can be reduced and intravenous cannulation is technically easier compared with EMLA alone.
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Anaesth Intensive Care · Jun 1996
Randomized Controlled Trial Comparative Study Clinical TrialComparison of subcutaneous ring block of the penis with caudal epidural block for post-circumcision analgesia in children.
A randomized, prospective, blind trial was conducted comparing caudal epidural blockade (caudal block) with subcutaneous ring block of the penis (penile ring block) in fifty healthy boys between two and twelve years of age undergoing elective circumcision. Subjects receiving caudal block had a longer duration of analgesia (P = 0.003), and took longer to first micturition (P = 0.04) but there was no difference in time taken to awaken from anaesthesia or spontaneously walk unaided. ⋯ It is concluded that both techniques are effective. Caudal block is more reliable and produces a longer duration of analgesia but penile ring block is inherently safer and has a lower incidence of adverse effects.