British journal of anaesthesia
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Comparative Study
Post-tetanic count at adductor pollicis is a better indicator of early diaphragmatic recovery than train-of-four count at corrugator supercilii.
Because the intensity of neuromuscular block at the diaphragm (DIA) is indirectly assessed, the electromyographic measurements of the DIA (DIA(EMG)) from surface electrodes were related to information provided by visual estimation of neuromuscular transmission at the adductor pollicis (AP) and the corrugator supercilii (CSC) during recovery from vecuronium block. ⋯ PTC(AP) may better reflect early recovery of vecuronium-induced DIA paralysis than TOF(CSC). The findings suggested that PTC(AP)
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Randomized Controlled Trial
Changes in a surgical stress index in response to standardized pain stimuli during propofol-remifentanil infusion.
The surgical stress index (SSI) is based on a sum of the normalized pulse beat interval (PBI) and the pulse wave amplitude (PPGA) time series of the photoplethysmography. As a measure of the nociception-anti-nociception balance in response to a standardized pain stimulus, SSI was compared with EEG changes in state and response entropy (SE and RE), PPGA, and heart rate (HR) during various targeted pseudo-steady-state concentrations of propofol and remifentanil. ⋯ SSI appeared to be a better measure of nociception-anti-nociception balance than SE, RE, HR, or PPGA.
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Randomized Controlled Trial Comparative Study
Comparison of i.v. cannula and Stevens' cannula for sub-Tenon's block.
Sub-Tenon's local anaesthesia (STLA) is growing in popularity for ophthalmic surgery, and is widely regarded as safer than the alternative sharp needle techniques. Although safe, STLA is not devoid of risk. Therefore, the effectiveness of a plastic i.v. cannula was compared with the traditional metal Stevens' cannula for delivering STLA. ⋯ A 20 G Optiva i.v. cannula and the Stevens' sub-Tenon's cannula were equally effective at providing STLA.
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Comparative Study
Clinical evaluation of the FloTrac/Vigileo system and two established continuous cardiac output monitoring devices in patients undergoing cardiac surgery.
Assessment of cardiac output (CO) by the FloTrac/Vigileo system may offer a less invasive means of determining the CO than either the pulmonary artery catheter (PAC) or the PiCCOplus system. The aim of this study was to compare CO measurements made using the FloTrac/Vigileo system with upgraded software (FCO, Edwards Lifesciences, Irvine CA, USA), the PiCCOplus system (PCO, Pulsion Medical Systems, Munich, Germany) and continuous CO monitoring using a PAC (CCO; Vigilance monitoring, Edwards Lifesciences, Irvine CA, USA) with intermittent pulmonary artery thermodilution (ICO). The study was conducted in patients undergoing elective cardiac surgery. ⋯ The performance of the FloTrac/Vigileo system, the PiCCOplus, and the Vigilance CCO monitoring for CO measurement were comparable when tested against intermittent thermodilution in patients undergoing elective cardiac surgery.
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We report a case of lumbar radiculopathy after zygapophyseal joint injections for chronic low back pain. The management of the patient and potential causes for the radiculopathy are discussed. The case acts as a reminder that the spinal nerve roots should be considered when performing intra-articular facet joint injections and demonstrates the importance of including nerve injury in the patient consent process as a rare, but significant complication.