Anaesthesia
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Randomized Controlled Trial Comparative Study
A randomised, crossover comparison between the CobraPLA and the LMA Classic in paralysed patients.
We performed a randomised, crossover study in 38 anaesthetised and paralysed patients to compare the performance of the CobraPLA and the LMA Classic during controlled ventilation. The median (IQR [range]) airway leak pressure was 23.0 (20-24 [12-30]) cmH(2)O for the CobraPLA and 15.0 (12-19 [8-30]) cmH(2)O for the LMA Classic (p < 0.001). The median (IQR [range]) insertion time was 15.0 (11-26 [9-31]) s for the CobraPLA and 22.5 (20-25 [15-50]) s for the LMA Classic (p < 0.001). ⋯ There were no adverse events during anaesthesia. The CobraPLA provides a better airway leak pressure and takes less time to insert than the LMA Classic in paralysed patients. Our data show that the CobraPLA can be used to secure a patent airway during controlled ventilation in selected patients.
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The Department for International Development (DFID) is the UK government department with responsibility for managing Britain's aid to poor countries, with an overall budget of pound 5.3 billion in 2007-8. Our health strategy is to strengthen healthcare systems by working in partnership with governments and other stakeholders in public health in assisted countries. DFID also supports a substantial research programme, principally in health and education.
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The Primary Trauma Care programme is a course designed to train anaesthetists, surgeons and others in the systematic review and management of severe trauma victims at the District Hospital. Over the last 10 years, many individuals have been involved in training, empowering and supporting doctors and nurses in a number of countries. ⋯ The Primary Trauma Care Foundation continues to support these regional offices in their need for qualified instructors, fund-raising, and for updating educational material. With anaesthetic support, the Primary Trauma Care Foundation will continue to empower anaesthetists worldwide as they work with their surgical colleagues to treat severely injured patients in areas where, previously, due to inadequate resources and training, comprehensive treatment was not available.
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The World Health Organization has been involved in a wide range of global healthcare initiatives for many years. Recently an initiative 'Safe Surgery Saves Lives' has been launched to improve the safety of surgery throughout the world. Safe anaesthesia is a key component to achieving this aim.
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Randomized Controlled Trial Comparative Study
A randomised comparison of the single use LMA Flexible with the reusable LMA Flexible in paediatric dental day-case patients.
In this study we compared the performance of the single use flexible laryngeal mask airway (LMA Flexible) with the original reusable LMA Flexible in paediatric dento-alveolar day-case surgery. The aim of the study was to determine whether these two supraglottic airway devices were clinically equivalent when used for simple dental extractions in children under general anaesthesia. This randomised comparative trial in 100 healthy children used first attempt airway insertion success as its primary outcome measure. ⋯ Both devices performed equally well during surgery, with no significant differences in episodes of intra-operative airway compromise (p = 0.387), and both the single use and reusable LMA Flexible displayed excellent recovery characteristics, with no occurrences of emergence airway obstruction. No blood was discovered within the inner LMA tube shaft in either device, implying that both protected against tracheobronchial soiling. We conclude therefore that the single use LMA Flexible is an acceptable alternative to the reusable LMA Flexible.