Anaesthesia
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Comparative Study Clinical Trial Controlled Clinical Trial
Cerebral oximetry: a useful monitor during carotid artery surgery.
Cerebral oximetry was evaluated as a monitor of oxygenation during carotid endarterectomy in 22 patients. The oximeter was a reliable continuous monitor, identifying changes in cerebral oxygenation during episodes of hypotension and after arterial occlusion. ⋯ There was no correlation between internal carotid artery stump pressure and change in cerebral oxygenation after application of the arterial cross clamp. However, cerebral oxygenation correlated weakly with the change in middle cerebral artery velocity as measured by transcranial Doppler ultrasonography (r = 0.49, p < 0.02).
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of ondansetron and droperidol in reducing postoperative nausea and vomiting associated with patient-controlled analgesia.
In a randomised, placebo-controlled trial we have compared the efficacy of ondansetron and droperidol in reducing postoperative nausea and vomiting associated with patient-controlled analgesia after orthopaedic surgery. One hundred and forty five patients, ASA 1 and 2, undergoing major orthopaedic surgery were anaesthetised using a standardised technique. They were randomly allocated to receive patient-controlled analgesia as morphine 1 mg.ml-1 alone; morphine as before plus a single dose of 1.25 mg droperidol together with 0.083 mg.ml-1 in the infusion syringe; or morphine as before plus 4 mg ondansetron and 0.13 mg.ml-1 in the syringe. ⋯ The number of patients suffering from nausea alone was not significantly different between the three groups, although those in the ondansetron group experienced less severe nausea (p < 0.05) when using a two point scale. The droperidol group had significantly higher sedation scores than the other two groups (p < 0.005). We conclude that ondansetron is superior to droperidol when used with patient-controlled analgesia and causes less sedation.
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Randomized Controlled Trial Clinical Trial
External high frequency oscillation in normal subjects and in patients with acute respiratory failure.
External high frequency oscillation was performed on 20 healthy volunteers using a cuirass-based system, the Hayek Oscillator. Five-min periods of oscillation were carried out on each subject at frequencies of 1, 2, 3, 4 and 5 Hz. Effective ventilation was measured in terms of the fall in alveolar partial pressure of carbon dioxide immediately after oscillation. ⋯ Using the same inspired oxygen fraction, the external high frequency oscillation replaced intermittent positive pressure ventilation for a 30-min period. External high frequency oscillation improved oxygenation by 16% and reduced the arterial carbon dioxide by 6%. These preliminary findings suggest that normal subjects and intensive care unit patients can be adequately ventilated by means of external high frequency oscillation.
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Randomized Controlled Trial Clinical Trial
SCOTI--a new device for identification of tracheal intubation.
A new lightweight device for the detection of placement of a tracheal tube in the trachea or oesophagus is described. The device utilises a sonic technique detecting resonating frequencies in an open (trachea) or closed (oesophagus) structure. Evaluation of the device in a clinical environment is described and it has been shown to be capable of verifying the correct placement of the tracheal tube in the trachea in 98% of patients studied. Further evaluation of this intubating aid appears justified.
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Clinical Trial Controlled Clinical Trial
Gastric regurgitation during general anaesthesia in different positions with the laryngeal mask airway.
Ninety patients, divided into three groups of 30, were investigated to determine the incidence of gastric regurgitation during general anaesthesia administered via the laryngeal mask airway in the supine, Trendelenburg and lithotomy positions. Fifteen minutes before induction of anaesthesia each patient swallowed a 75 mg methylene blue capsule. At the end of surgery, the LMA and the oropharynx were inspected for bluish discoloration which was considered to be a sign of gastric regurgitation. No blue dye was detected in the supine group but it was observed in one patient in each of the other two groups.