British journal of anaesthesia
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This project was devised to estimate the incidence of major complications of airway management during anaesthesia in the UK and to study these events. ⋯ Although these data suggest the incidence of death and brain damage from airway management during general anaesthesia is low, statistical analysis of the distribution of reports suggests as few as 25% of relevant incidents may have been reported. It therefore provides an indication of the lower limit for incidence of such complications. The review of airway management indicates that in a majority of cases, there is 'room for improvement'.
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Randomized Controlled Trial Comparative Study
Remifentanil patient-controlled analgesia effect-site target-controlled infusion compared with morphine patient-controlled analgesia for treatment of acute pain after uterine artery embolization.
Post-procedural pain control after uterine artery embolization (UAE) of urethral leiomyomata remains a major problem. ⋯ Remifentanil PCA-TCI with a slow and progressive adapted algorithm without any associated premedication or co-medication is feasible in young healthy women undergoing UAE.
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Multicenter Study
ICU fire evacuation preparedness in London: a cross-sectional study.
Hospital fires present a sporadic but significant threat to patients and staff. This is especially so within an intensive care unit (ICU) setting, due to the complexity of moving acutely unwell patients reliant on invasive monitoring and organ support. Despite an average of 500 in-hospital fires reported to the UK department of health per annum, causing 65 injuries and 1-2 fatalities, the readiness of ICUs for urgent evacuation has not been assessed. ⋯ Forward planning for an urgent evacuation can be improved.
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Randomized Controlled Trial
Continuous care and empathic anaesthesiologist attitude in the preoperative period: impact on patient anxiety and satisfaction.
Continuous care (one anaesthesiologist per patient) and anaesthesiologist empathy at the preoperative visit could affect patient anxiety and satisfaction. We tested both unproven issues in a population at increased risk of anxiety and dissatisfaction. ⋯ The 'one patient, one anaesthesiologist' model, in addition to ensuring sufficient time for open discussion and questions at the preoperative visit, improved patient satisfaction.
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This study was performed to assess whether intubation is more difficult in obese patients and to assess the ability of a new index: the ratio of the neck circumference to thyromental distance (NC/TM), to predict difficult intubation in obese patients. ⋯ Difficult intubation was more common in obese patients and the NC/TM was a better method for predicting difficult intubation than other established indices.