British journal of anaesthesia
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Randomized Controlled Trial Multicenter Study
Prospective randomized controlled multi-centre trial of cuffed or uncuffed endotracheal tubes in small children.
The use of cuffed tracheal tubes (TTs) in small children is still controversial. The aim of this study was to compare post-extubation morbidity and TT exchange rates when using cuffed vs uncuffed tubes in small children. ⋯ The use of cuffed TTs in small children provides a reliably sealed airway at cuff pressures of
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Randomized Controlled Trial
Magnesium sulphate has beneficial effects as an adjuvant during general anaesthesia for Caesarean section.
The use of low concentrations of volatile anaesthetics with avoidance of opioids may induce intraoperative awareness and adverse haemodynamic responses during Caesarean section. Magnesium is well known to reduce anaesthetic requirements and to block noxious stimuli. We investigated whether i.v. magnesium sulphate modulates anaesthetic depth and analgesic efficacy during Caesarean section. ⋯ Preoperative i.v. magnesium sulphate attenuated BIS and arterial pressure increases during the pre-delivery period. Magnesium sulphate can be recommended as an adjuvant during general anaesthesia for Caesarean section to avoid perioperative awareness and pressor response resulting from inadequate anaesthesia, analgesia, or both.
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Comparative Study
Determination of serum propofol concentrations by breath analysis using ion mobility spectrometry.
We aimed to measure propofol concentrations in exhaled air with an ion mobility spectrometer coupled to a multicapillary column for pre-separation (MCC-IMS). In addition, we aimed to compare the values of these measurements with serum propofol concentrations, as determined by gas chromatography-mass spectrometry (GC-MS). ⋯ MCC-IMS may be a suitable method to determine propofol concentrations in exhaled air, and may be used to predict propofol concentrations in serum.
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Comparative Study
Comparison of different methods of ventilation via cannula cricothyroidotomy in a trachea-lung model.
Cannula cricothyroidotomy is recommended in recent guidelines as a rescue intervention in the 'cannot-intubate cannot-ventilate' scenario. Several methods of providing ventilation via a cannula cricothyroidotomy have been described, but there are no data comparing these methods and using cannulae of differing diameters. ⋯ Extrapolated to the clinical situation, these data suggest that low-pressure devices will not deliver adequate MVs via a cannula cricothroidotomy and should no longer be advocated. Purpose-made devices should be available in all areas where anaesthesia is administered or airway interventions are performed.
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The incidence of asthma is increasing worldwide, but morbidity and mortality are decreasing because of improvements in medical care. Although the incidence of severe perioperative bronchospasm is relatively low in asthmatics undergoing anaesthesia, when it does occur it may be life-threatening. ⋯ Many routinely used anaesthetic agents have an ameliorative effect on airway constriction. Nonetheless, acute bronchospasm can still occur, especially at induction and emergence, and should be promptly and methodically managed.