British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Effect of preoperative amino acid infusion on thermoregulatory response during spinal anaesthesia.
Intravenous amino acid infusion during general anaesthesia prevents decreases in core temperature resulting from increased energy expenditure and heat accumulation. ⋯ Preoperative infusion of amino acids effectively prevents spinal anaesthesia-induced hypothermia by maintaining a higher metabolic rate and increasing the threshold core temperature for thermal vasoconstriction.
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Randomized Controlled Trial Clinical Trial
Randomized evaluation of the performance of single-use laryngoscopes in simulated easy and difficult intubation.
Single-use laryngoscopes are becoming used more widely. ⋯ Of the laryngoscopes tested, the standard reusable Macintosh laryngoscope performed best. The Europa was the best single-use laryngoscope. Some single-use laryngoscopes tested were significantly inferior to the Macintosh. This raises concern over their use in clinical practice, particularly if intubation is difficult.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the effects of sevoflurane and propofol on cooling and rewarming during deliberate mild hypothermia for neurosurgery.
Because the time available for cooling and rewarming during deliberate mild hypothermia is limited, studies of the rate of the cooling and rewarming are useful. The decrease in core hypothermia caused by heat redistribution depends on the anaesthetic agent used. We therefore investigated possible differences between sevoflurane and propofol on the decrease and recovery of core temperature during deliberate mild hypothermia for neurosurgery. ⋯ Sevoflurane-based anaesthesia did not affect cooling and rewarming for deliberate mild hypothermia compared with propofol-based anaesthesia.
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Case Reports
Postpartum cerebral ischaemia after accidental dural puncture and epidural blood patch.
Puerperal women are reported to have a rate of cerebral infarction 13 times greater than non-pregnant females. We report a case of cerebral ischaemia in a 30-yr-old healthy parturient after epidural analgesia for labour, complicated by dural puncture treated with two epidural blood patches. ⋯ At 1-yr follow-up, the patient had homonymous hemianopsia. We discuss the possible causative mechanism of the cerebral ischaemia in relation to the dural puncture and epidural blood patch.
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Comparable minimum alveolar concentration (MAC) fractions of volatile anaesthetics produce similar thermoregulatory impairment. Nitrous oxide, however, decreases the vasoconstriction threshold less than sevoflurane or isoflurane. We tested the hypothesis that nitrous oxide also decreases shivering threshold less than isoflurane alone or in combination. ⋯ This study indicates that nitrous oxide reduces the shivering threshold less than isoflurane.