British journal of anaesthesia
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Randomized Controlled Trial Comparative Study
Obstetric analgesia: a comparison of patient-controlled meperidine, remifentanil, and fentanyl in labour.
To compare the analgesic efficacy of remifentanil with meperidine and fentanyl in a patient-controlled setting (patient-controlled analgesia, PCA). ⋯ The efficacy of meperidine, fentanyl, and remifentanil PCA for labour analgesia varied from mild to moderate. Remifentanil PCA provided better analgesia than meperidine and fentanyl PCA, but only during the first hour of treatment. In all groups, pain scores returned to pre-treatment values within 3 h after the initiation of treatment.
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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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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.
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Randomized Controlled Trial
Effect of increased body mass index and anaesthetic duration on recovery of protective airway reflexes after sevoflurane vs desflurane.
Increased BMI may increase the body's capacity to store potent inhaled anaesthetics, more so with more soluble agents. Accordingly, we asked whether increased BMI and longer anaesthesia prolonged airway reflex recovery. ⋯ Prolonged sevoflurane administration and greater BMI delay airway reflex recovery. The contribution of BMI to this delay is more pronounced after sevoflurane than desflurane.