British journal of anaesthesia
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Our aim was to estimate the ED95 of prilocaine 1% w/v for femoral nerve block. ⋯ Our study demonstrates that the dose closest to the ED(95) of prilocaine 1% w/v for ultrasound-guided femoral nerve block is 17 ml. The study also illustrates the value of CRM in dose-finding experiments.
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Although telemedicine is one of the key initiatives of the World Health Organization, no study has explored the feasibility and efficacy of teleanaesthesia. This bi-centre pilot study investigates the feasibility of transcontinental anaesthesia. ⋯ Transcontinental anaesthesia is feasible; control of anaesthesia shows good performance indexes. Clinical registration number NCT01331096.
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Randomized Controlled Trial
Pain vs comfort scores after Caesarean section: a randomized trial.
The use of negative words, such as 'sting' and 'pain', can increase patient pain and anxiety. We aimed to determine how pain scores compare with comfort scores and how the technique of pain assessment affects patient perceptions and experiences after operation. ⋯ Asking about pain and pain scores after Caesarean section adversely affects patient reports of their postoperative experiences.
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Review Case Reports
Problems in obtaining sufficient anaesthesia with propofol and remifentanil: three cases, a test infusion, and a review.
Over a 5 yr period, we have encountered three patients in whom remifentanil appeared to have no clinical effect during general anaesthesia (GA). We describe seven anaesthetics in these three patients. ⋯ The potential causes of this effect are discussed. We advise clinicians to be aware of this unusual response to remifentanil. If such a response is suspected, we recommend the use of another opioid. If this is suspected before GA, we propose the use of our test as a diagnostic tool.
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Controlled Clinical Trial
Visual metaphors on anaesthesia monitors do not improve anaesthetists' performance in the operating theatre.
Previous research using a metaphorical anaesthesia monitor, where dimensions of rectangles proportionally represent 30 patient variable values, showed improved performance in diagnosing adverse events compared with the standard monitor. Steady-state values were represented by a frame around each rectangle. We developed a similar metaphorical anaesthesia interface, but instead of presenting four relatively simple complications, we presented 10 complications of various levels of difficulty. Our simplified monitor presented variables that anaesthetists and trainees suggested as being essential for diagnosis. ⋯ Visual metaphors on anaesthesia monitors do not improve anaesthetists' performance in the operating theatre. Since all complications in this study were identifiable based on monitor values alone, it seems feasible to develop a decision support system (DSS) based on these values. We suggest that a DSS could support the anaesthetist by calling attention to diagnoses that may not be considered.