British journal of anaesthesia
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The technology and clinical understanding of anatomical sonography has evolved greatly over the past decade. In the Department of Anaesthesia and Intensive Care Medicine at the Medical University of Vienna, ultrasonography has become a routine technique for regional anaesthetic nerve block. Recent studies have shown that direct visualization of the distribution of local anaesthetics with high-frequency probes can improve the quality and avoid the complications of upper/lower extremity nerve blocks and neuroaxial techniques. ⋯ The advantages over conventional guidance techniques, such as nerve stimulation and loss-of-resistance procedures, are significant. This review introduces the reader to the theory and practice of ultrasound-guided anaesthetic techniques in adults and children. Considering their enormous potential, these techniques should have a role in the future training of anaesthetists.
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Randomized Controlled Trial Comparative Study Clinical Trial
Clonidine as an adjuvant to local anaesthetic axillary brachial plexus block: a randomized, controlled study.
We compared the effects of clonidine added to levobupivacaine and bupivacaine on axillary brachial plexus block as well as the effectiveness of levobupivacaine alone compared with bupivacaine alone. ⋯ These findings suggest responder and non-responder behaviour is a result of the addition of clonidine.
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Randomized Controlled Trial Clinical Trial
Haemodynamic effects of remifentanil in children with and without intravenous atropine. An echocardiographic study.
Remifentanil is known to cause bradycardia and hypotension. We aimed to characterize the haemodynamic profile of remifentanil during sevoflurane anaesthesia in children with or without atropine. ⋯ Remifentanil produced a fall in blood pressure and cardiac index, mainly as a result of a fall in heart rate. Although atropine was able to reduce the fall in heart rate, it did not completely prevent the reduction in cardiac index.
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Transcranial magnetic stimulation with motor evoked potential monitoring is a non-invasive method for monitoring motor tracts during surgery. However, anaesthetic agents such as propofol and volatile agents reduce responses to single transcranial magnetic stimulation. We assessed an intravenous technique for anaesthesia to allow motor evoked potentials (MEPs) to be monitored using repetitive transcranial magnetic stimulation (rTMS). ⋯ It is possible to monitor intraoperative MEP using rTMS during anaesthesia with propofol and remifentanil.