Anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Fibreoptic intubation. Influence of tracheal tube tip design.
A randomised study was carried out in 60 patients to assess the influence of tracheal tube tip design on the ease of railroading a tracheal tube during fibreoptic intubation. A new design of tracheal tube with a tapered tip, without a bevel, was compared with a tracheal tube of standard design. The new design was found to be greatly superior in both oro- and nasotracheal fibreoptic intubation, when compared with the traditional tracheal tube (p < 0.001). The shape of the tip of a tracheal tube is an important determinant of the ease of railroading the tube over an inserted fibrescope.
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Randomized Controlled Trial Comparative Study Clinical Trial
Zingiber officinale (ginger)--an antiemetic for day case surgery.
The effect of powdered ginger root was compared with metoclopramide and placebo. In a prospective, randomised, double-blind trial the incidence of postoperative nausea and vomiting was measured in 120 women presenting for elective laparoscopic gynaecological surgery on a day stay basis. The incidence of nausea and vomiting was similar in patients given metoclopramide and ginger (27% and 21%) and less than in those who received placebo (41%). ⋯ The requirements for postoperative analgesia, recovery time and time until discharge were the same in all groups. There was no difference in the incidence of possible side effects such as sedation, abnormal movement, itch and visual disturbance between the three groups. Zingiber officinale is an effective and promising prophylactic antiemetic, which may be especially useful for day case surgery.
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Comparative Study
Laryngeal mask airway insertion. A comparison of the standard versus neutral position in normal patients with a view to its use in cervical spine instability.
The ease of insertion of the laryngeal mask airway with the patient's head in the standard position and the neutral position was compared, in a study of 80 healthy patients. Successful insertion was assessed by fibreoptic bronchoscopy and the functioning of the airway. ⋯ There were no significant differences in scores as assessed by fibreoptic bronchoscopy. The laryngeal mask airway may have a role in the management of some patients with cervical spine instability, although confirmation of this ultimately depends on the results of outcome studies.
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The distance between the grille of the laryngeal mask airway and the vocal cords was measured with a fibreoptic bronchoscope in 30 male and 30 female patients. The mean distance was 3.6 cm (SD 0.5 cm; range 2.5-4.7 cm) in males and 3.1 cm (SD 0.5 cm; range 2.0-4.2 cm) in females. ⋯ To avoid this complication, the tracheal tube must protrude more than 9.5 cm beyond the grille of the laryngeal mask airway. When either neck extension or flexion is required, the laryngeal mask airway should be removed as the margin of safety is small.