Anaesthesia
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The efficacy of the laryngeal mask is widely accepted, but there is a lack of consensus on the best insertion method and on the use of the mask for certain surgical procedures. We sent a questionnaire to all anaesthetists in Wales to discover the frequency of use of the laryngeal mask and the preferred insertion method. The questionnaire also enquired about the use of the laryngeal mask during anaesthesia for laparoscopic clip sterilisation. ⋯ The next most popular option was insertion of the mask with the cuff partially inflated. Twenty-three per cent of consultants and 34% of non-consultants were prepared to use the laryngeal mask during anaesthesia for laparoscopic clip sterilisation. Although the insertion technique described in the instruction manual is the most widely employed, a large number of alternative methods are frequently used.
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An audit project was designed to assess and improve the provision of postoperative analgesia in a children's hospital. Pain assessment for all children and analgesia standards for our institution were introduced prior to data collection. ⋯ The initial prescription of analgesia increased from 95% to 98% (p = 0.019), administration of analgesia to children experiencing bad or severe pain increased from 57% to 71% (p = 0.032) and the number of children experiencing severe pain reduced from 17% to 11% (p = 0.050). Application of audit, by a clinical nurse specialist, enabled us to achieve and demonstrate improvements in the prescription, administration and effectiveness of postoperative analgesia.