British journal of anaesthesia
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Randomized Controlled Trial
Minimal local anaesthetic volumes for sciatic nerve block: evaluation of ED 99 in volunteers.
This randomized, double-blinded volunteer study was designed to evaluate the ED(99) volume of local anaesthetic for sciatic nerve blocks using a step-up/step-down methodology. ⋯ This is the first study where an ED(99) volume of local anaesthetic for sciatic nerve block has been evaluated. The resulting local anaesthetic volume of 0.10 ml mm(-2) cross-sectional nerve area seems to have no impact on sensory onset time, whereas the duration of sensory block is shorter.
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Randomized Controlled Trial Comparative Study
Comparison of early cognitive function and recovery after desflurane or sevoflurane anaesthesia in the elderly: a double-blinded randomized controlled trial.
Postoperative cognitive dysfunction (POCD) is being recognized as a complication contributing to perioperative morbidity and mortality of the elderly. We hypothesized that the use of the shorter-acting volatile anaesthetic desflurane would be associated with less incidence of POCD when compared with sevoflurane. ⋯ The total incidence of POCD showed no differences between the desflurane and the sevoflurane groups. However, the tests Well-being scale, DST, and Trail Making Test, emergence times, and patients' satisfaction were in favour of desflurane.
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Postoperative nausea and vomiting (PONV) is common and of concern to patients and clinicians. The effect of PONV can range from trivial and transient to major clinical importance, and it is unclear which of its characteristics lead to discomfort and distress. ⋯ The PONV Intensity Scale is a valid, reliable, and responsive measure of clinically important PONV.
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The clinical picture in severe cases of pandemic (H1N1) 2009 influenza is markedly different from the disease pattern seen during epidemics of seasonal influenza, in that many of those affected were previously healthy young people. Current predictions estimate that, during a pandemic wave, 12-30% of the population will develop clinical influenza (compared with 5-15% for seasonal influenza) with 4% of those patients requiring hospital admissions and one in five requiring critical care. This review covers the background, clinical presentation, diagnosis, and treatment. ⋯ Guidance from a range of bodies has been produced in a relatively short period of time in response to pandemic (H1N1) 2009 influenza. Disease severity has the potential to change, especially if there is virus mutation. Clinicians must be prepared for the unexpected and continue to share their experiences to maximize patient outcomes.
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Randomized Controlled Trial
Effect of desflurane at less than 1 MAC on QT interval prolongation induced by tracheal intubation.
Desflurane at more than 1 minimum alveolar concentration (MAC) has been shown to prolong the QT interval, but it is unclear whether this is the case at lower concentrations. The aim of this study was to determine whether desflurane concentrations of <1 MAC affect tracheal intubation-induced prolongation of the QT interval. ⋯ The administration of desflurane at an inspiratory concentration of 1 MAC during manually controlled ventilation after anaesthesia induction with propofol did not affect tracheal intubation-induced QTc prolongation.