British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of cricoid pressure on ease of insertion of the laryngeal mask airway.
We have evaluated the effects of cricoid pressure on laryngeal mask airway (LMA) insertion after an elective rapid sequence induction in 100 patients allocated randomly to two groups. An attempt was made to insert the LMA after application of cricoid pressure in one group and with no pressure in the other. The anaesthetist was blinded to the application of cricoid pressure. Insertion was successful in 45 of 50 patients in the cricoid pressure group and in 49 of 50 patients in the non-cricoid group (P < 0.1) We discuss the implications of these findings for failed intubation in the nonfasted patient.
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Randomized Controlled Trial Comparative Study Clinical Trial
Antiemetic efficacy of prophylactic ondansetron in laparoscopic surgery: randomized, double-blind comparison with metoclopramide.
In a randomized, double-blind study, we have compared the prophylactic antiemetic efficacy of ondansetron with that of metoclopramide in 123 patients undergoing general anaesthesia for day-case gynaecological laparoscopic surgery. The patients received either i.v. ondansetron 4 mg or metoclopramide 10 mg immediately before a standard anaesthetic. ⋯ In those patients with a previous history of postoperative nausea and vomiting, nausea was less severe in those receiving ondansetron compared with those receiving metoclopramide (P < 0.05). We conclude that preoperative prophylactic administration of i.v. ondansetron was superior to metoclopramide in preventing nausea and vomiting after general anaesthesia for day-case gynaecological laparoscopic surgery.
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Randomized Controlled Trial Clinical Trial
Effect of extradural diamorphine on analgesia after caesarean section under subarachnoid block.
We have examined the efficacy, duration of action and side effects of extradural diamorphine alone and in combination with 1:200,000 adrenaline in a randomized, double-blind controlled study of 45 patients who underwent Caesarean section under spinal anaesthesia. Saline 10 ml, diamorphine 2.5 mg in saline 10 ml or diamorphine 2.5 mg in 1:200,000 adrenaline 10 ml were administered via the extradural route at delivery of the baby. ⋯ The addition of adrenaline increased the quality of analgesia 8 h after operation, but had no effect on the total amount of i.m. morphine administered during the first 24 h. The incidence of side effects was similar in all groups.
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Randomized Controlled Trial Clinical Trial
Lung management during cardiopulmonary bypass: is continuous positive airways pressure beneficial?
It is not clear if the use of continuous positive airway pressure (CPAP) during cardiopulmonary bypass (CPB) improves lung function after cardiac surgery. We have measured alveolar-arterial oxygen partial pressure difference (PAO2-PaO2) in 61 patients undergoing elective coronary artery bypass surgery. ⋯ The time to extubation (P = 0.42) and early extubation (P = 0.87) were not affected by the use of CPAP. The results of this study do not support the use of CPAP during CPB as a mechanism of improving lung function after cardiac surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Radiological examination of the intrathecal position of microcatheters in continuous spinal anaesthesia.
There have been few studies of the intrathecal position of spinal catheters in continuous spinal anaesthesia. This prospective study was designed to examine radiologically the intrathecal position of 28-gauge spinal catheters. ⋯ The intrathecal position of the catheters did not depend on the level of the lumbar puncture (P = 0.6246), but was dependent on the position of the patient during insertion of the catheter (P = 0.0093), and on the depth of insertion (P = 0.0099). Our study suggests that patients should be in a sitting position during insertion of a subarachnoid microcatheter and that the depth of insertion should not exceed 4 cm.