British journal of anaesthesia
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Recent studies have linked the use of regional anaesthesia to improved outcomes. Epidemiological research on utilization, trends, and disparities in this field is sparse; however, large nationally representative database constructs containing anaesthesia-related data, demographic information, and multiyear files are now available. Together with advances in research methodology and technology, these databases provide the foundation for epidemiological research in anaesthesia. ⋯ Finally, significant disparities and variability in anaesthetic care seem to exist based on demographic and health-care-related factors. With anaesthesia playing an increasingly important part in population-based health-care delivery and evidence indicating improved outcome with use of regional anaesthesia, more research in this area is needed. Furthermore, prevalent disparities and variabilities in anaesthesia practice need to be specified further and addressed in the future.
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Randomized Controlled Trial
Dexamethasone alone vs in combination with transcutaneous electrical acupoint stimulation or tropisetron for prevention of postoperative nausea and vomiting in gynaecological patients undergoing laparoscopic surgery.
Postoperative nausea and vomiting (PONV) is commonly reported after surgery and anaesthesia. We compared the effects of combinations of electrical acupoint stimulation or tropisetron with dexamethasone with the effects of dexamethasone alone, for inhibition of PONV in gynaecological patients undergoing laparoscopic surgery. ⋯ NCT 02096835.
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Clinical Trial
Optimal volume of local anaesthetic for adductor canal block: using the continual reassessment method to estimate ED95.
Theoretically, the ideal volume of local anaesthetic for adductor canal block (ACB) would ensure sufficient filling of the canal and avoid proximal spread to the femoral triangle. In this dose-finding study, we aimed to investigate the minimal effective volume for an ACB needed to fill the adductor canal distally in at least 95% of patients (ED95). ⋯ NCT02033356.
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Randomized Controlled Trial
Deep neuromuscular block improves the surgical conditions for laryngeal microsurgery.
Adequate neuromuscular block is required throughout laryngeal microsurgery. We hypothesized that the surgical conditions would improve under a deeper level of rocuronium-induced neuromuscular block. ⋯ NCT01980069.
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Multicenter Study
Incidence and risk factors for intensive care unit admission after bariatric surgery: a multicentre population-based cohort study.
With increasing rates of bariatric surgery and the consequential involvement of increasingly complex patients, uncertainty remains regarding the use of intensive care unit (ICU) services after bariatric surgery. Our objective was to define the incidence, indications, and outcomes of patients requiring ICU admission after bariatric surgery and assess whether unplanned ICU admission could be predicted using preoperative factors. ⋯ Intensive care unit admission after bariatric surgery was uncommon (4.9% of all patients), with 30.9% of all referrals being unplanned. A nomogram and smartphone application based on five important preoperative factors may assist anaesthetists to conduct preoperative planning for high-risk bariatric surgical patients.