British journal of anaesthesia
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Randomized Controlled Trial Meta Analysis
Tranexamic acid in hip fracture surgery: a randomized controlled trial.
Hip fracture surgery may be associated with substantial blood loss. This study was designed to assess the efficacy and safety of the use of tranexamic acid in hip fracture surgery for the reduction of erythrocyte transfusion. ⋯ In hip fracture surgery, tranexamic acid reduces erythrocyte transfusion but may promote a hypercoagulable state. Thus, further evaluation of safety is required before recommending the off-label use of tranexamic acid.
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Randomized Controlled Trial Multicenter Study
Combined acetaminophen and ibuprofen for pain relief after oral surgery in adults: a randomized controlled trial.
Acetaminophen is often used with a non-steriodal anti-inflammatory drug for acute pain. Hitherto, these drugs have had to be given separately, typically at different time intervals. Maxigesic tablets combine acetaminophen and ibuprofen in clinically appropriate doses to simplify administration and dosage regimen. We compared this combination with each of the constituent drugs for the relief of pain after extraction of third molar teeth. ⋯ Maxigesic tablets provide superior pain relief after oral surgery to acetaminophen or ibuprofen alone.
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Randomized Controlled Trial Comparative Study
Comparison of two ventilatory strategies in elderly patients undergoing major abdominal surgery.
'Open lung' ventilation is commonly used in patients with acute lung injury and has been shown to improve intraoperative oxygenation in obese patients undergoing laparoscopic surgery. The feasibility of an 'open lung' ventilatory strategy in elderly patients under general anaesthesia has not previously been assessed. ⋯ A lung recruitment strategy in elderly patients is well tolerated and improves intraoperative oxygenation and lung mechanics during laparotomy.
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Case Reports
Pentax-AWS videolaryngoscope for awake nasal intubation in patients with unstable necks.
In patients with unstable necks and at risk of pulmonary aspiration, awake fibreoptic intubation is often appropriate. However, stabilization of the neck can make fibreoptic intubation more difficult. I report the use of awake nasal intubation using the Pentax-Aiway Scope (AWS) in three patients with restricted neck movement, in whom awake fibreoptic intubation had failed. ⋯ Although it was possible to insert a fibreoptic bronchoscope into the trachea while the neck was stabilized with a Halo vest, it was impossible to advance a tube over the fibrescope. Awake nasotracheal intubation using the Pentax-AWS was achieved within 15 s. The Pentax-AWS may be useful for nasotracheal intubation in awake patients with restricted necks.