British journal of anaesthesia
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Pulse transit time (rPTT), the interval between ventricular electrical activity and arrival of a peripheral pulse waveform, has been used to detect changes in autonomic tone. The aim of this observational pilot study was to measure changes in rPTT in response to general anaesthesia and noxious stimuli. ⋯ Variation in rPTT reflects autonomic responses to nociceptive stimulation and fluctuations in anaesthetic depth independently of heart rate.
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Randomized Controlled Trial Comparative Study Clinical Trial
Optimization of desflurane administration in morbidly obese patients: a comparison with sevoflurane using an 'inhalation bolus' technique.
The concept of an 'inhalation bolus' can be used to optimize inhaled drug administration. We investigated the depth of anaesthesia, haemodynamic stability, and recovery time in morbidly obese patients resulting from bispectral index (BIS)-guided sevoflurane or desflurane administration and BIS-triggered inhalation boluses of sevoflurane or desflurane combined with titration of remifentanil. ⋯ Immediate recovery was significantly faster in the desflurane group. Overall hypnotic controllability measured by BIS was less accurate with desflurane. Overall haemodynamic controllability was better when using desflurane. Fewer episodes of hypotension were found in the desflurane group. The use of the inhalation bolus was found to be appropriate in both groups without causing severe haemodynamic side effects. Minimal BIS values were significantly lower after a desflurane bolus.
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized crossover comparison of the ProSeal laryngeal mask airway with the Laryngeal Tube during anaesthesia with controlled ventilation.
The Laryngeal Tube (LT) performs similarly to the classic laryngeal mask airway during controlled ventilation but with an improved airway seal. We compared the laryngeal tube with the ProSeal laryngeal mask airway (PLMA) throughout anaesthesia. ⋯ The two devices performed equally well in terms of seal pressure. The PLMA was quicker to insert. Efficacy of ventilation was significantly better with the PLMA than the LT. The PLMA allowed a significantly better view of the larynx with a fibre-optic laryngoscope, and may therefore be of more use in cases where visualization of the larynx is required.
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Randomized Controlled Trial Clinical Trial
Sequential compression device with thigh-high sleeves supports mean arterial pressure during Caesarean section under spinal anaesthesia.
This study investigated the use of a Sequential Compression Device (SCD) with thigh-high sleeves and a preset pressure of 50 mm Hg that recruits blood from the lower limbs intermittently, as a method to prevent spinal hypotension during elective Caesarean section. Possible association of arterial pressure changes with maternal, fetal, haemodynamic, and anaesthetic factors were studied. ⋯ SCD use in conjunction with vasopressor significantly reduced the incidence of a 20% reduction of MAP.
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Randomized Controlled Trial Comparative Study Clinical Trial
Randomized comparison of the classic Laryngeal Mask Airway with the Airway Management Device during anaesthesia.
We compared the modified Airway Management Device (AMD) with the classic Laryngeal Mask Airway (cLMA) in a randomized comparative trial. ⋯ Successful insertion of the cLMA is more likely than that of the AMD. Insertion of the AMD required more attempts and caused a greater number of complications. Fibre-optic position was poorer than with the cLMA. When an airway is established, the AMD caused a greater number of complications during anaesthesia and failed more frequently than the cLMA. During recovery from anaesthesia, more complications occurred with the AMD. Overall performance of the AMD was poorer than with the classic LMA.