British journal of anaesthesia
-
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.
-
Randomized Controlled Trial Clinical Trial
Unconscious auditory priming during surgery with propofol and nitrous oxide anaesthesia: a replication.
Priming during anaesthesia has been hard to replicate and the conditions under which it occurs remain poorly understood. We replicated and extended a recent study to determine whether intraoperative priming during propofol and nitrous oxide anaesthesia is a reliable phenomenon, whether it occurs due to awareness during word presentation and whether it is suppressed by a dose of fentanyl at induction. ⋯ Existing knowledge can be primed by information presented during propofol and nitrous oxide anaesthesia. This priming is evidence of unconscious information processing and not the result of moments of awareness.
-
Clinical Trial Controlled Clinical Trial
Effect of obesity and thoracic epidural analgesia on perioperative spirometry.
Lung volumes in obese patients are reduced significantly in the postoperative period. As the effect of different analgesic regimes on perioperative spirometric tests in obese patients has not yet been studied, we investigated the effect of thoracic epidural analgesia and conventional opioid-based analgesia on perioperative lung volumes measured by spirometry. ⋯ We conclude that EDA should be considered in obese patients undergoing midline laparotomy to improve postoperative spirometry.
-
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.