British journal of anaesthesia
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Randomized Controlled Trial Comparative Study
Comparison of high- and low-dose intrathecal morphine for spinal fusion in children.
The purpose of this prospective study was to assess the blood-sparing effect, the quality of analgesia, and the incidence of side-effects of a low-dose regime of intrathecal opioids (ITO) when compared with those of a high-dose regime in scoliosis surgery in children. ⋯ Intrathecal administration of opioids significantly reduces blood loss and postoperative opioid demand, thereby showing side-effects comparable with the control group. These effects were already seen with the low-dose regimen and high dose did not further improve efficacy.
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Randomized Controlled Trial Comparative Study
Pentax-AWS, a new videolaryngoscope, is more effective than the Macintosh laryngoscope for tracheal intubation in patients with restricted neck movements: a randomized comparative study.
We studied whether laryngoscopy and tracheal intubation were easier when using the Pentax-AWS (Tokyo, Japan), a new videolaryngoscope, than when applying the Macintosh laryngoscope, during manual in-line neck stabilization. ⋯ In patients with stabilized neck, the Pentax-AWS provided a better view of the glottis and a higher success rate of tracheal intubation, compared with the conventional Macintosh laryngoscope.
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Early haemodynamic assessment is of particular importance in the evaluation of haemodynamically compromised patients, but is often precluded by the invasiveness and complexity of the established cardiac output (CO) monitoring techniques. The FloTrac/Vigileo system allows minimally invasive CO determination based on the arterial pressure waveform derived from any standard arterial catheter, and the algorithm underlying CO calculation was recently modified to allow a more precise estimate of aortic compliance. ⋯ Despite the updated algorithm, AP-CO still showed a limited agreement with the reference-CO and systematically underestimated the CO so that the method is not suitable to replace invasive CO monitoring at present.