Anaesthesia
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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.
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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.
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Randomized Controlled Trial
Comparison of the incidence and severity of cough induced by sufentanil and fentanyl: a prospective, randomised, double-blind study.
We compared the incidence and severity of cough following a bolus of sufentanil with that following fentanyl in 510 patients, randomly allocated to receive sufentanil 0.3 microg.kg(-1), fentanyl 3 microg.kg(-1) or 5 ml sterile water intravenously over 5 s. Coughing was graded depending on the number of coughs as mild (1-2), moderate (3-5) and severe (> 5). ⋯ Sufentanil was also associated with a lesser severity (p = 0.039) of coughing compared with fentanyl. We conclude that equipotent boluses of sufentanil and fentanyl increase the incidence of cough, although the incidence and severity of coughing with sufentanil are less than those with fentanyl.
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In modern anaesthesia practice, regional techniques are preferred to general anaesthesia for many types of surgery, particularly in obstetric care. Improved outcomes have been recorded in UK practice, but the techniques remain underutilised in many parts of the world. With encouragement, training and a regular supply of appropriate needles and local anaesthetic agents, the advantages of regional techniques in the developing world could be realised.
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Randomized Controlled Trial
Pre-operative analgesia with rectal diclofenac and/or paracetamol in children undergoing inguinal hernia repair.
Both rectal diclofenac and paracetamol are commonly used to treat acute postoperative pain in children but combining them to improve the quality of analgesia is controversial. This study aimed to detect whether the pre-operative combined administration of rectal diclofenac and paracetamol is superior to either drug alone. One hundred and eight patients were randomly assigned to receive either rectal diclofenac 1 mg.kg(-1) or paracetamol 40 mg.kg(-1) or their combination 1 h prior to surgery. ⋯ If the patients experienced a pain score of 2 or more, morphine was given. The total dose of morphine and number of doses required were recorded. Children who received the rectal diclofenac-paracetamol combination experienced a lower pain scale and a decreased need for morphine compared with children receiving each drug alone.