British journal of anaesthesia
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Randomized Controlled Trial
Effect of a small priming dose on myoclonic movements after intravenous anaesthesia induction with Etomidate-Lipuro in children.
In children, the incidence of injection pain at i.v. anaesthetic induction with Etomidate-Lipuro is low when compared with propofol mixed with lidocaine (5%). However, the incidence of involuntary myoclonic movements (MM) after induction of anaesthesia is higher compared with propofol (85% vs. 15%). In adults, the incidence of MM is reported to be significantly reduced if a small priming dose is administered immediately before the main injection of etomidate. The aim of this prospective, randomized, double-blind, placebo-controlled clinical trial was to investigate if a small priming dose of etomidate effectively can reduce the incidence of MM also in children. ⋯ Children in the age range of 5-10 yr appear to be especially prone to react with involuntary MM after i.v. induction of anaesthesia with etomidate. The use of a small, non-sedative, priming dose did not influence the incidence of involuntary MM after i.v. induction of anaesthesia with etomidate in children 1-15 yr of age.
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Randomized Controlled Trial
Ultrasound assessment of cranial spread during caudal blockade in children: the effect of different volumes of local anaesthetics.
Despite the large amount of literature on caudal anaesthesia in children, the issue of volume of local anaesthetics and cranial spread is still not settled. Thus, the aim of the present prospective randomized study was to evaluate the cranial spread of caudally administered local anaesthetics in children by means of real-time ultrasound, with a special focus on the effects of using different volumes of local anaesthetics. ⋯ The main finding of the present study was positive, but numerically small correlation between injected volumes of local anaesthetic and the cranial spread of caudally administered local anaesthetics. Therefore, the prediction of the cranial spread of local anaesthetic, depending on the injected volume of the local anaesthetic, was not possible. EudraCT Number: 2008-007627-40.
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Randomized Controlled Trial Comparative Study
Effect of phenylephrine and ephedrine bolus treatment on cerebral oxygenation in anaesthetized patients.
How phenylephrine and ephedrine treatments affect global and regional haemodynamics is of major clinical relevance. Cerebral tissue oxygen saturation (Sct(O2) )-guided management may improve postoperative outcome. The physiological variables responsible for Sct(O2) changes induced by phenylephrine and ephedrine bolus treatment in anaesthetized patients need to be defined. ⋯ Associated with changes in CO, decreased after phenylephrine treatment, but remained unchanged after ephedrine treatment. The significant correlation between CO and implies a cause-effect relationship between global and regional haemodynamics.
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Randomized Controlled Trial Comparative Study
Comparison of intermediate vs subcutaneous cervical plexus block for carotid endarterectomy.
Carotid endarterectomy surgery can be performed under regional anaesthesia alone or under general anaesthesia. However, there are several types of regional block available and reported complication rates after superficial cervical plexus blocks are significantly lower than deep blocks. It is not known if subcutaneous and intermediate blocks are equally effective, although anatomical evidence suggests that the latter (where the injectate diffuses below the deep cervical fascia) might provide superior quality of intraoperative anaesthesia. ⋯ Intermediate and subcutaneous cervical plexus blocks are equally effective for carotid endarterectomy. This study adds to the body of evidence supporting the safe use of superficial blocks for this type of surgery.