British journal of anaesthesia
-
Randomized Controlled Trial Comparative Study Clinical Trial
Predicted values of propofol EC50 and sevoflurane concentration for insertion of laryngeal mask Classic and ProSeal.
A new laryngeal mask airway, the ProSeal (PLMA), is said to be more difficult to insert than the laryngeal mask airway Classic (CLMA) using propofol anaesthesia. Therefore, we expected a greater dose of propofol and sevoflurane to be required to insert the PLMA compared with the CLMA. We determined the effective concentration 50% (EC(50)) of propofol and end-tidal sevoflurane to allow insertion of the PLMA and the CLMA. ⋯ The estimated concentration of propofol and the sevoflurane concentration needed to allow insertion of the ProSeal are respectively 38 and 20% greater than those needed for insertion of the Classic LMA.
-
Randomized Controlled Trial Clinical Trial
Relation between fentanyl dose and predicted EC50 of propofol for laryngeal mask insertion.
This study sought to determine the effective concentration for 50% of the attempts to secure laryngeal mask insertion (predicted EC(50LMA)) of propofol using a target-controlled infusion (Diprifusor) and investigated whether fentanyl influenced these required concentrations, respiratory rate (RR) and bispectral index (BIS). ⋯ A fentanyl dose of 0.5 micro g kg(-1) is sufficient to decrease predicted EC(50LMA) with minimum respiratory depression and without a high BIS value.
-
We describe the locked-in syndrome in a 31-yr-old patient after right upper lobectomy for suspected metastasis. After surgery, vertical eye movement was her only means of communication. ⋯ Post-mortem examination showed extensive metastatic tumour deposition in the ventral pons. We discuss the clinical features of this syndrome and factors that may affect onset, diagnosis and management.
-
The coronavirus which causes severe acute respiratory syndrome (SARS) is a virulent and highly contagious organism. Of the 1755 SARS patients in Hong Kong, over 400 were healthcare workers. ⋯ These points are especially pertinent when anaesthetizing SARS patients for high-risk procedures such as tracheostomy. We describe the management of such a case.