British journal of anaesthesia
-
Randomized Controlled Trial Multicenter Study Clinical Trial
Transfusion requirements in critical care (TRICC): a multicentre, randomized, controlled clinical study. Transfusion Requirements in Critical Care Investigators and the Canadian Critical care Trials Group.
-
A 63-yr-old woman was anaesthetized for sub-total thyroidectomy. The thyroid gland was large, deviating the trachea to the right and causing 30% tracheal narrowing at the level of the suprasternal notch. Mask ventilation was easy but laryngoscopy was Cormack and Lehane grade 3. ⋯ An intubating laryngeal mask was inserted and although the airway was clear and ventilation easy, it was not possible to intubate the trachea either blindly or with the fibreoptic bronchoscope. Tracheal intubation was eventually achieved using a 6.5-mm cuffed oral tracheal tube via a size 4 laryngeal mask under fibreoptic control. We describe the case in detail and discuss the use of the intubating laryngeal mask, its potential limitations and how to optimize its use in similar circumstances.
-
Comparative Study Clinical Trial Controlled Clinical Trial
Comparison of the effects of sevoflurane and isoflurane on arterial oxygenation during one lung ventilation.
We have compared the effects of sevoflurane and isoflurane on arterial oxygenation, heart rate and mean arterial pressure during one lung anaesthesia in a prospective, crossover study. We studied 28 patients undergoing oesophagogastrectomy, allocated alternatively to one of two groups. Patients in group I/S (n = 14) received 1 MAC (1.1%) of isoflurane in oxygen from induction until the end of 30 min of open chest one lung ventilation (OLV) in the lateral position. ⋯ In the subgroup of patients with pulmonary artery catheters (n = 12), we found a significant increase (P < 0.05) in derived shunt during sevoflurane anaesthesia. There was no significant difference in mixed venous saturation and cardiac output. We conclude that during one lung ventilation, the choice between sevoflurane and isoflurane did not significantly influence arterial oxygenation.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Intranasal midazolam for premedication of children undergoing day-case anaesthesia: comparison of two delivery systems with assessment of intra-observer variability.
Midazolam is often used for paediatric premedication. We have compared two methods of administering midazolam intranasally in 44 surgical day-case children allocated randomly to receive midazolam 0.2 mg kg-1 as drops or midazolam 0.1 mg kg-1 from an intranasal spray device. Behaviour was recorded on a four-point scale by the parent, nurse and anaesthetist. ⋯ There was no significant difference in the assessments between observers. Midazolam by either method was equally effective but acceptability of the premedication was poor in both groups. Intranasal midazolam cannot be recommended as a method for routine premedication of young children.