Anaesthesia
-
Randomized Controlled Trial
M-Entropy guidance vs standard practice during propofol-remifentanil anaesthesia: a randomised controlled trial.
Seventy-two patients undergoing routine surgical procedures under propofol-remifentanil anaesthesia were randomly assigned to receive either standard clinical practice (n = 35) or standard practice plus monitoring of depth of anaesthesia with M-Entropy (n = 37). Patients in the standard practice group received more propofol than the entropy group (mean (SD) 95 (14) vs 81 (22) microg.kg(-1).min(-1), respectively; p < 0.01), and less remifentanil (0.39 (0.08) vs 0.46 (0.08) microg.kg(-1).min(-1), respectively; p < 0.001). ⋯ Both regimens resulted in fast recovery with no clinical advantage for either one. There were no significant differences in haemodynamic parameters, postoperative nausea and vomiting or satisfaction with the procedure.
-
Good quality educational material for anaesthesia providers in the developing world is limited in both quantity and availability. Traditionally, textbooks have been the main source of information but these are frequently expensive, easily damaged and rapidly become outdated. Many first world texts concentrate on the use of expensive drugs for an increasingly complex range of patients and procedures, making them less suitable for practitioners in resource-poor locations. Improved access to broadband internet connections will increasingly be a major portal for the delivery of up to date educational material.
-
An anaesthetic charity 'Mothers of Africa' has been established as a link between the academic departments of anaesthesia in Togo and Benin and the University Hospital of Wales. Visits by UK consultant anaesthetists have identified a number of clinical areas where collaborative working in both classroom and theatre has the potential to improve outcomes in maternal mortality and morbidity.
-
Global Oximetry (GO) is an initiative launched recently in Uganda, India, the Philippines and Vietnam. The overall aims are to promote oximetry utilisation and reduce oximetry costs in lower income countries. Research objectives include studying the feasibility of cost reduction; overcoming non-cost barriers to global oximetry including issues of prioritization; education and guidelines; servicing and access to parts. Promotional objectives include creating new policy, influencing oximetry design, and setting new global standards for safer monitoring.