British journal of anaesthesia
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This clinical study evaluated the speed of reversal of profound rocuronium block in ponies using sugammadex and investigated the differences in onset and recovery from block in three different muscle groups. ⋯ Sugammadex can be used to reverse profound rocuronium-induced block in ponies during isoflurane anaesthesia. Thoracic limb muscles represent a suitable alternative for monitoring neuromuscular block compared with pelvic limb muscles.
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Randomized Controlled Trial
Intravenous lidocaine infusion reduces bispectral index-guided requirements of propofol only during surgical stimulation.
I.V. lidocaine reduces volatile anaesthetics requirements during surgery. We hypothesized that lidocaine would also reduce propofol requirements during i.v. anaesthesia. ⋯ The sparing effect of lidocaine on anaesthetic requirements seems to be mediated by an anti-nociceptive action.
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Randomized Controlled Trial
Xylometazoline pretreatment reduces nasotracheal intubation-related epistaxis in paediatric dental surgery.
Epistaxis is the most common complication encountered during nasotracheal intubation (NTI) in children. The aim of this study was to test the efficacy of prophylactic intranasal admixture of xylometazoline and local anaesthetic gel in reducing epistaxis after NTI in children. ⋯ Admixture of intranasal xylometazoline 0.1% drops and lidocaine 2% jelly reduced the incidence and severity of epistaxis after NTI in preschool children.
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Paravertebral blockade (PVB) is a regional anaesthetic technique with a large number of indications. PVB is usually performed with landmark-based techniques or methods that rely on pressure differences between the extra- and intraparavertebral space. This consecutive case series was designed to describe the ultrasound appearance of the lateral thoracic paravertebral space (PVS) and develop an ultrasound-guided method for PVB. ⋯ After ultrasound identification of the boundaries of the lateral PVS, an out-of-plane needle guidance technique facilitated successful PVB. There were no clinically relevant correlations between morphometric data and ultrasound measurements.
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The use of intraoperative cell salvage and autologous blood transfusion has become an important method of blood conservation. The main aim of autologous transfusion is to reduce the need for allogeneic blood transfusion and its associated complications. Allogeneic blood transfusion has been associated with increased risk of tumour recurrence, postoperative infection, acute lung injury, perioperative myocardial infarction, postoperative low-output cardiac failure, and increased mortality. ⋯ Cell salvage should be considered in all cases where significant blood loss (>1000 ml) is expected or possible, where patients refuse allogeneic blood products or they are anaemic. The use of cell salvage in combination with a leucocyte depletion filter appears to be safe in obstetrics and cases of malignancy; however, further trials are required before definitive guidance may be provided. The only absolute contraindication to the use of cell salvage and autologous blood transfusion is patient refusal.