British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Analgesic efficacy of rectal acetaminophen and ibuprofen alone or in combination for paediatric day-case adenoidectomy.
Acetaminophen and non-steroidal anti-inflammatory drugs have different mechanisms of action. We investigated if combining rectal acetaminophen with ibuprofen would provide better postoperative analgesia compared with either drug alone after adenoidectomy in children. ⋯ We conclude that prophylactically administered rectal acetaminophen combined with ibuprofen does not improve analgesia after adenoidectomy in the immediate postoperative period compared with either drug alone but does decrease the need for analgesia at home. Ibuprofen results in lesser sedation and faster discharge than when acetaminophen is used.
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Randomized Controlled Trial Clinical Trial
Detection of awareness in surgical patients with EEG-based indices--bispectral index and patient state index.
Patient state index (PSI) and bispectral index (BIS) are values derived from the EEG, which can measure the hypnotic component of anaesthesia. We measured the ability of PSI and BIS to distinguish consciousness from unconsciousness during induction and emergence from anaesthesia and a period of awareness in surgical patients. ⋯ Despite significant differences between mean values at responsiveness and non-responsiveness for BIS and PSI, neither measure may be sufficient to detect awareness in an individual patient, reflected by a P(k) less than below 70%.
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Randomized Controlled Trial Clinical Trial
Randomized comparison of laryngeal tube with classic laryngeal mask airway for anaesthesia with controlled ventilation.
Only a prototype laryngeal tube has been compared with the classic LMA for brief periods of anaesthesia. We compared the new laryngeal tube (which had several improvements in design) with the classic LMA. ⋯ The laryngeal tube was as effective as the classic LMA during anaesthesia with controlled ventilation. There were similar operative and postoperative complications.
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The pro- and anti-inflammatory cytokine balance has been implicated in outcome from inflammatory conditions, and cardiopulmonary bypass is associated with a marked inflammatory response. Interleukin-10 (IL-10) is an anti-inflammatory cytokine and levels have been shown to be highest in those patients who develop sepsis after trauma or surgery. IL-10 levels vary between individuals and genotype may dictate the IL-10 response. We therefore investigated IL-10 genotype, circulating IL-10 concentrations and outcome in terms of organ dysfunction 24 h after cardiopulmonary bypass. ⋯ The G allele of the -1082 base pair single nucleotide polymorphism in the IL-10 gene is associated with lower IL-10 release after cardiopulmonary bypass. High levels of IL-10 secretion are associated with organ dysfunction 24 h after surgery.