Anaesthesia
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Randomized Controlled Trial
Intranasal dexmedetomidine following failed chloral hydrate sedation in children.
Chloral hydrate is the most commonly used sedative for paediatric diagnostic procedures in China with a success rate of around 80%. Intranasal dexmedetomidine is used for rescue sedation in our centre. This prospective investigation evaluated 213 children aged one month to 10 years who were not adequately sedated following administration of chloral hydrate. ⋯ Successful rescue sedation in groups 1, 2 and 3 were 56 (83.6%), 66 (89.2%) and 51 (96.2%), respectively. Increasing the rescue dose was associated with an increased success rate with an odds ratio of 4.12 (95% CI 1.13-14.98), p = 0.032. We conclude that intranasal dexmedetomidine is effective for sedation in children who do not respond to chloral hydrate.
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Qualitative research methods are a group of techniques designed to allow the researcher to understand phenomena in their natural setting. A wide range is used, including focus groups, interviews, observation, and discourse analysis techniques, which may be used within research approaches such as grounded theory or ethnography. ⋯ Meticulous social scientific methods, transparency, reproducibility and reflexivity are markers of quality in qualitative research. Tools such as the consolidated criteria for reporting qualitative research checklist and the critical appraisal skills programme are available to help authors, reviewers and readers unfamiliar with qualitative research assess its merits.
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We compared the force of extraction for peripheral nerve catheters under three different situations in a porcine model using untunnelled, tunnelled and double-tunnelled catheters. Following insertion of the catheter into the porcine model, the catheters were either left untunnelled or a single or double tunnel was created for the catheter. ⋯ Tunnelling a peripheral nerve catheter leads to a significant increase in the force required for dislodgement. This is increased further by introducing a second tunnel.
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Review Meta Analysis
The efficacy of peri-operative interventions to decrease postoperative delirium in non-cardiac surgery: a systematic review and meta-analysis.
The purpose of this meta-analysis was to determine the efficacy of peri-operative interventions in decreasing the incidence of postoperative delirium. An electronic search of four databases was conducted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were adhered to. ⋯ Meta-analysis revealed that peri-operative geriatric consultation (OR 0.46, 95% CI 0.32-0.67) and lighter anaesthesia (OR 2.66, 95% CI 1.27-5.56) were associated with a decreased incidence of postoperative delirium. For the other interventions, the point estimate suggested possible protection with prophylactic haloperidol (OR 0.62, 95% CI 0.36-1.05), bright light therapy (OR 0.20, 95% CI 0.03-1.19) and general as opposed to regional anaesthesia (OR 0.76, 95% CI 0.47-1.23). This meta-analysis has shown that peri-operative geriatric consultations with multicomponent interventions and lighter anaesthesia are potentially effective in decreasing the incidence of postoperative delirium.