British journal of anaesthesia
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Anaphylaxis during anaesthesia is a rare event that in ∼60-70% of cases is secondary to neuromuscular blocking agents. It has been suggested previously that the recent introduction of sugammadex may provide a novel therapeutic approach to the management of rocuronium-induced anaphylaxis. ⋯ This was associated with an improvement in the adverse haemodynamic state. The underlying reasons for this are unclear, but sugammadex may potentially be a useful adjunct in the management of rocuronium-induced anaphylaxis.
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The first stage of the Royal College of Anaesthetists Fourth National Audit Project (NAP4) (to determine the incidence of major complications of airway management in the UK) required a national census of airway management techniques currently in use. ⋯ The second stage of NAP4 is designed to register and collect details of each major airway complication from the same hospitals over a 12 month period. The individual case reports will produce the numerator to calculate the incidence of airway complications associated with general anaesthesia in the UK. The results of the census presented here will provide the denominator.
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Randomized Controlled Trial
Intubating conditions and adverse events during sevoflurane induction in infants.
The aim of this study was to compare intubating conditions and adverse events after sevoflurane induction in infants, with or without the use of rocuronium or alfentanil. ⋯ In 1- to 24-month-old infants, the addition of 0.3 mg kg⁻¹ rocuronium to 8% sevoflurane improved intubating conditions and decreased the frequency of respiratory adverse events. Alfentanil provided no additional benefit in this study.
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Randomized Controlled Trial
Effect of high-dose preoperative methylprednisolone on pain and recovery after total knee arthroplasty: a randomized, placebo-controlled trial.
Total knee arthroplasty (TKA) is associated with severe pain and inflammation despite an extensive multimodal analgesic approach, but the effect of high-dose glucocorticoid administration has not been studied. ⋯ MP 125 mg before surgery improves analgesia and immediate recovery after TKA, even when combined with a multimodal analgesic regime. These findings call for further studies on safety aspects.