British journal of anaesthesia
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Randomized Controlled Trial
Effect of intravenous vasopressor on spread of spinal anaesthesia and fetal acid-base equilibrium.
We previously found rostral spread of spinal plain levobupivacaine to be less with prophylactic i.v. phenylephrine than with ephedrine during Caesarean delivery. This study investigated whether rostral spread of spinal hyperbaric bupivacaine is also less with phenylephrine than with ephedrine. ⋯ In contrast to its effect on spinal plain levobupivacaine, we did not find rostral spread of spinal hyperbaric bupivacaine to be less with prophylactic phenylephrine than with ephedrine. We observed an unexpectedly high incidence of fetal acidosis with ephedrine and found evidence that longer spinal-delivery intervals increase the risk of fetal acidosis developing with ephedrine, but not phenylephrine.
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The cost-benefit relationship for depth of anaesthesia monitors is complicated by the high cost of specially designed EEG electrodes. The cerebral state index (CSI) monitor will accept regular ECG electrodes with snap connectors. The purpose of this study was to determine if generic ECG electrodes could replace the more expensive proprietary EEG electrodes for the CSI monitor. ⋯ Switching from proprietary EEG electrodes to ordinary generic ECG electrodes maintains the same accuracy at about a 10th of the cost when measuring CSI during day surgery with sevoflurane anaesthesia.
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Randomized Controlled Trial Comparative Study
Oral clonidine vs midazolam in the prevention of sevoflurane-induced agitation in children. a prospective, randomized, controlled trial.
This randomized, double-blind study tested the hypothesis that, in comparison with midazolam, premedication with oral clonidine reduces the incidence of emergence agitation in preschool children anaesthetized with sevoflurane. ⋯ In comparison with midazolam, clonidine 4 microg kg-1 reduced sevoflurane-induced emergence agitation without increasing postoperative side-effects.
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Randomized Controlled Trial Multicenter Study Comparative Study
Multicentre evaluation of the adenosine agonist GR79236X in patients with dental pain after third molar extraction.
Adenosine is analgesic in humans, and the selective adenosine A1 receptor agonist GR79236X has significant anti-nociceptive activity in an animal pain model of inflammatory pain. ⋯ We found no evidence of efficacy of GR79236 compared with placebo, but the active control diclofenac was effective. It is possible that a higher dose of GR79236 might have been effective or that i.v. administration of this drug does not achieve appropriate concentrations in the brain or peripheral nerves.
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Sugammadex is the first selective relaxant binding agent and reverses rocuronium-induced neuromuscular block. A case is reported in which a patient accidentally received a high dose of sugammadex (40 mg kg-1) to reverse a rocuronium-induced (1.2 mg kg-1) profound neuromuscular block. A fast and efficient recovery from profound neuromuscular block was achieved and no adverse events or other safety concerns were reported.