British journal of anaesthesia
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Randomized Controlled Trial Comparative Study
Intermittent vs continuous administration of epidural ropivacaine with fentanyl for analgesia during labour.
Many years ago regular intermittent bolus administration of epidural local anaesthetic solution was recognized to produce more effective analgesia than continuous infusion, but only recently has the development of suitable pumps allowed the former technique's wider evaluation. ⋯ The intermittent group required fewer supplementary injections and less drug to maintain similar pain scores, sensory and motor block compared with the continuous group. This represents a more efficacious mode of analgesia.
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Multicenter Study
Perioperative fluid therapy in children: a survey of current prescribing practice.
Fluid therapy in children may be associated with iatrogenic hyponatraemia. We surveyed anaesthetists' current fluid prescribing practice during the perioperative period, departmental fluid protocols and awareness of the concerns of the Royal College of Paediatrics and Child Health (RCPCH) about the use of dextrose 4%/saline 0.18% in children. ⋯ The prescription of hypotonic dextrose saline solutions by anaesthetists may be putting children at risk from iatrogenic hyponatraemia. Departmental protocols for perioperative fluid prescription in children are uncommon. We suggest that national guidance is required.
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Randomized Controlled Trial
The effect of addition of intrathecal clonidine to hyperbaric bupivacaine on postoperative pain and morphine requirements after Caesarean section: a randomized controlled trial.
Intrathecal clonidine prolongs spinal anaesthesia. We investigated the effect of the addition of clonidine (75 microg) to hyperbaric bupivacaine on postoperative morphine consumption after Caesarean section in a randomized controlled double-blind trial. ⋯ The addition of clonidine (75 microg) to hyperbaric bupivacaine prolongs spinal anaesthesia after Caesarean section and improves early analgesia, but does not reduce the postoperative morphine consumption during the first 24 h. No clinically relevant maternal or neonatal side-effects were detected.
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The GlideScopeVideo Laryngoscope is a new intubating device. The aim of the study was to investigate the use of the GlideScopefor tracheal intubation in patients with ankylosing spondylitis (AS) undergoing general anaesthesia. ⋯ The GlideScope provides a better laryngoscopic view than that of direct laryngoscopy. Most of the AS patients presenting with MCLS grade III or IV by direct laryngoscopy can be intubated successfully by the GlideScope. In elective patients with AS, awake fibreoptic intubation offers a higher level of security because it can be applied while maintaining spontaneous breathing. The use of GlideScope for tracheal intubation may be an alternative option in these patients who prefer their airway management under anaesthesia.