British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Development of a difficulty score for spinal anaesthesia.
Multiple attempts at spinal puncture may be hazardous. Accurate preoperative prediction of difficulty adds to the delivery of high quality care. This clinical trial was designed to: (i). determine the predictive performance of difficulty variables; (ii). compare senior and junior anaesthetists; (iii). develop a score to predict difficulty during the performance of spinal anaesthesia. ⋯ Spinal bony landmarks and radiological characteristics of the lumbar vertebrae are independent predictors of difficulty during spinal anaesthesia. There is no difference between senior and junior anaesthetists. Grade 4 is the difficulty score at or above which difficulty is expected.
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Standardized scenarios can be used for performance assessments geared to the level of the learner. The purpose of this study was to validate checklists used for the assessments of medical students' performance using high-fidelity patient simulation. ⋯ Five scenarios developed for this study were shown to be valid when using the faculty criteria for expected performance level.
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Randomized Controlled Trial Clinical Trial
Effect of three anaesthetic techniques on isometric skeletal muscle strength.
Our aim was to quantify human involuntary isometric skeletal muscle strength during anaesthesia with propofol, sevoflurane, or spinal anaesthesia using bupivacaine. ⋯ At clinically relevant concentrations, propofol and sevoflurane did not influence involuntary isometric skeletal muscle strength in adults, whereas spinal anaesthesia reduced strength by about 20%. Muscle strength assessment using a device such as described here provided reliable results and should be considered for use in other scientific investigations to identify potential effects of anaesthetic agents.