British journal of anaesthesia
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Editorial Comment
A poisoned chalice: the heritage of parental anaesthesia exposure.
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Randomized Controlled Trial Comparative Study
Comparison of nebulised dexmedetomidine, ketamine, or midazolam for premedication in preschool children undergoing bone marrow biopsy.
The aim of our study was to compare the efficacy of dexmedetomidine, ketamine, and midazolam for sedative premedication administered by nebuliser 30 min before general anaesthesia in preschool children undergoing bone marrow biopsy and aspiration. ⋯ NCT02935959.
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The link between exposure to general anaesthesia and surgery (exposure) and cognitive decline in older adults is debated. We hypothesised that it is associated with cognitive decline. ⋯ In older adults, exposure to general anaesthesia and surgery was associated with a subtle decline in cognitive z-scores. For an individual with no prior exposure and with exposure after enrolment, the decline in cognitive function over a 5 yr period after the exposure would be 0.2 standard deviations more than the expected decline as a result of ageing. This small cognitive decline could be meaningful for individuals with already low baseline cognition.
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Recent evidence that programmed intermittent epidural bolus (PIEB) improves maternal outcomes encouraged us to change our labour epidural analgesia protocols and investigate if we could achieve similar results in a clinical setting. ⋯ Benefits of PIEB+PCEA over CEI previously demonstrated in small randomised controlled trials were reproducible on a larger scale in a clinical setting.