Anaesthesia
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Review Meta Analysis Comparative Study
Pentax Airway Scope(®) vs Macintosh laryngoscope for tracheal intubation in adult patients: a systematic review and meta-analysis.
Despite increasing the likelihood of a Cormack-Lehane grade 1 view, pooled results from the studies showed no difference between the Pentax Airway Scope and standard Macintosh laryngoscope for:
- Rate of intubation on first attempt.
- Time for intubation.
- Incidence of oral or pharyngeal injury.
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Randomized Controlled Trial
The effect of pre-treatment with transcutaneous electrical acupoint stimulation on the quality of recovery after ambulatory breast surgery: a prospective, randomised controlled trial.
Electroacupuncture has been demonstrated to be effective at alleviating pain and postoperative side-effects. Our aim was to investigate whether transcutaneous electric acupoint stimulation, a low-skill alternative to needle-based electroacupuncture, could improve the quality of recovery after ambulatory surgery. Seventy-two women scheduled for cosmetic breast surgery were randomly allocated to transcutaneous electric acupoint stimulation or sham groups. ⋯ We found significant mean (SD) differences between the transcutaneous electric acupoint stimulation and sham groups in the mean (SD) length of recovery room stay (35.6 (12.9) min vs 48.3 (16.3) min, p = 0.01), time to removal of the laryngeal mask airway (10.2 (2.5) min vs 17.8 (4.4) min, p = 0.01), and time to reorientation of the patient (14.6 (3.2) min vs 26.5 (5.0) min, p = 0.01). Further, postoperative pain scores and the incidence of side-effects were all lower in the transcutaneous electric acupoint stimulation group. In conclusion, transcutaneous electric acupoint stimulation can significantly improve the quality of recovery and decrease the incidence of anaesthesia-related side-effects for patients undergoing ambulatory surgery.
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Toxic dose limits (mg.kg(-1)) for local anaesthetics based on body weight are well-established, but calculation of the maximum safe volume (ml) of a given agent and formulation is complex, and frequently results in errors. We therefore developed a nomogram to perform this calculation. We compared the performance of the nomogram with a spreadsheet and a general purpose calculator using simulated clinical data. ⋯ The nomogram produced fewer and smaller errors compared with the calculator. Our nomogram calculates the maximum safe volume (ml) of local anaesthetic to a clinically acceptable degree of accuracy. It facilitates rapid cross-checking of dosage calculations performed by electronic or other means at negligible cost, and can potentially reduce the incidence of local anaesthetic toxicity.