Anaesthesia
-
Randomized Controlled Trial Comparative Study
A prospective randomised double blind study to evaluate the effect of peribulbar block or topical application of local anaesthesia combined with general anaesthesia on intra-operative and postoperative complications during paediatric strabismus surgery.
We studied 45 ASA I/II children aged between 2 and 13 years scheduled for elective strabismus surgery, randomly allocated to receive either a peribulbar block or topical lidocaine 2% combined with general anaesthesia, or general anaesthesia alone. The incidence and severity of the occulocardiac reflex, the requirement for atropine, the occurrence of arrhythmias and incidence of postoperative nausea and vomiting following surgery at 1, 2 and 4 h were studied. We found the incidence and severity of occulocardiac reflex intra-operatively was significantly reduced in children who received a peribulbar block. The incidence of postoperative nausea and vomiting was significantly reduced in patients receiving either peribulbar block or topical local anaesthesia combined with general anaesthesia, compared to general anaesthesia alone (p = 0.008).
-
Randomized Controlled Trial Comparative Study
A comparison of the disposable vs the reusable laryngeal tube in paralysed adult patients.
A disposable laryngeal tube (LT-D) with dimensions identical to, but physical properties different from (stiffer tube/thicker cuff), the reusable laryngeal tube (LT-R) has recently become available. We performed a randomised, single blind trial among 100 anaesthetised and paralysed patients to compare these devices in terms of ease of insertion, airway sealing pressure, position assessed fibreoptically and postoperative throat complications. Anaesthesia was administered with midazolam, fentanyl, propofol, atracurium, oxygen and isoflurane. ⋯ There were no differences in airway sealing pressure, fibreoptic position or post operative sore throat and dysphagia. The intra cuff pressure remained stable for the LT-R but decreased slightly for the LT-D. In paralysed, anaesthetised patients, the single use and reusable laryngeal tubes are similar in clinical performance.
-
Randomized Controlled Trial
A comparison of dexmedetomidine and midazolam for sedation in third molar surgery.
This randomised, double-blind study compared dexmedetomidine and midazolam for intravenous sedation during third molar surgery under local anaesthesia. Sixty patients received either dexmedetomidine (up to 1 microg x kg(-1)) or midazolam (up to 5 mg), which was infused until the Ramsay Sedation Score was four or the maximum dose limit was reached. Intra-operative vital signs, postoperative pain scores and analgesic consumption, amnesia, and satisfaction scores for patients and surgeons, were recorded. ⋯ There was no significant difference in satisfaction or pain scores. Midazolam was associated with greater amnesia. Dexmedetomidine produces comparable sedation to midazolam.
-
Randomized Controlled Trial Comparative Study
A comparison of direct and indirect laryngoscopes and the ILMA in novice users: a manikin study.
Direct laryngoscopic tracheal intubation using the Macintosh laryngoscope is taught to many healthcare professionals as it is a potentially life-saving procedure. However, it is a difficult skill to acquire and maintain. Several alternative intubation devices exist that may provide a better view of the glottis and require less skill to use. ⋯ The Airtraq and ILMA reduced the severity of dental trauma in both scenarios. The performance of the other devices studied was more variable. Overall, participants found that only the Airtraq was less difficult to use and they were more confident using it compared to the Macinosh laryngoscope.