British journal of anaesthesia
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Progesterone has long been known to have central effects, by reduced anaesthetic requirements as measured by minimum alveolar concentration (MAC) in various settings. However, other studies have contradicted these findings. Therefore, we compared the effect of progesterone on anaesthetic requirements in a mouse model. ⋯ We conclude that administration of exogenous progesterone injection at higher concentrations decreases anaesthetic requirement as defined by rolling response.
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Randomized Controlled Trial Multicenter Study
Lung recruitment and positive airway pressure before extubation does not improve oxygenation in the post-anaesthesia care unit: a randomized clinical trial.
Atelectasis is known to develop during anaesthesia and after operation atelectasis leads to impaired oxygenation. Lung recruitment manoeuvres, positive end-expiratory pressure (PEEP), and continuous positive airway pressure (CPAP) have been proposed for reduction of atelectasis but their benefits have not been shown to persist after operation. We proposed that a combination of these techniques before extubation would improve oxygenation after operation. ⋯ Postoperative oxygenation is not improved by a combination of a lung recruitment manoeuvre and maintenance of a positive airway pressure until extubation. Further research is needed to elucidate the mechanism of atelectasis on emergence from anaesthesia and to evaluate more invasive clinical strategies such as post-extubation CPAP. Trial registered at URL http://www.controlled-trials.com Identification number: ISRCTN32464251 (http://www.controlled-trials.com/ISRCTN32464251).
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Recent advances in cataract surgery techniques have enabled these to be performed under less invasive local anaesthetic techniques. As a result, ophthalmic surgeons are increasingly prepared to give the local anaesthesia to the patient themselves without the need for the presence of an anaesthetist. ⋯ The consultant eye surgeons, based on their judgement, are prepared to undertake a bigger proportion of cataract surgeries under local anaesthesia without the presence of an anaesthetist. This development is bound to have a significant impact on manpower planning for ophthalmic anaesthetists.
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The minimum effective volume of local anaesthetic needed to provide effective analgesia of the four main branches of the axillary brachial plexus is unknown. This study was performed to determine the minimum volume of local anaesthetic required to surround the nerves of the axillary brachial plexus and document onset and duration of sensory and motor effects. ⋯ We found that it is possible to surround each nerve of the axillary brachial plexus with 2-4 ml of local anaesthetic. We speculate that increasing this volume would produce blocks of quicker onset and longer duration while still using smaller volumes than previously thought.