Anesthesiology Medical Journal Abstracts
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Effects of anesthetic agents on seizure-induction with intra-cortical injection of convulsants
Epilepsy Research
Jan 2013
Effects of anesthetic agents on seizure-induction with intra-cortical injection of convulsants
Rationale: Studies of partial or generalized seizure pathophysiology often require the use of intact animals. Additionally, anesthesia may be required for ethical reasons or paralysis if instrumental measures require immobilization. We examined three commonly used injected anesthetic for their impact on seizures..Local Versus Epidural Anesthesia in Fast-Track Abdominal Aortic Surgery
Journal of Cardiothoracic and Vascular Anesthesia
Jan 2013
Local Versus Epidural Anesthesia in Fast-Track Abdominal Aortic Surgery
Objective: The aim of this study was to investigate a possible alternative to epidural anesthesia/analgesia. The authors compared thoracic epidural anesthesia/analgesia with continuous wound infiltration anesthesia/analgesia in patients scheduled for mini-invasive abdominal aortic surgery in a fast-track setting...β-Blockers and Volatile Anesthetics May Attenuate Cardioprotection by Remote Preconditioning in Adult Cardiac Surgery: A Meta-analysis of 15 Randomized Trials
Journal of Cardiothoracic and Vascular Anesthesia
Jan 2013
β-Blockers and Volatile Anesthetics May Attenuate Cardioprotection by Remote Preconditioning in Adult Cardiac Surgery: A Meta-analysis of 15 Randomized Trials
Objective: Clinical trials on cardioprotection by remote ischemic preconditioning (RIPC) for adult patients undergoing cardiac surgery revealed mixed results. Previous meta-analyses have been conducted and found marked heterogeneity among studies. The aim of this meta-analysis was to evaluate the factors affecting..Influence of Acidosis on Cardiotonic Effects of Colforsin and Epinephrine: A Dose-Response Study
Journal of Cardiothoracic and Vascular Anesthesia
Dec 2012
Influence of Acidosis on Cardiotonic Effects of Colforsin and Epinephrine: A Dose-Response Study
Objective: Acidosis produces a negative inotropic effect on cardiac muscle against which catecholamines and phosphodiesterase III inhibitors have limited therapeutic effects. This study evaluated the effects of colforsin, which directly activates adenylate cyclase without β-adrenergic receptor activation, in isolated..Sevoflurane Confers Additive Cardioprotection to Ethanol Preconditioning Associated With Enhanced Phosphorylation of Glycogen Synthase Kinase-3β and Inhibition of Mitochondrial Permeability Transition Pore Opening
Journal of Cardiothoracic and Vascular Anesthesia
Dec 2012
Sevoflurane Confers Additive Cardioprotection to Ethanol Preconditioning Associated With Enhanced Phosphorylation of Glycogen Synthase Kinase-3β and Inhibition of Mitochondrial Permeability Transition Pore Opening
Objective: The purposes of this study were to investigate whether sevoflurane (SEVO) enhances moderate-dose ethanol (EtOH) preconditioning and whether this additional cardioprotection is associated with glycogen synthase kinase-3β (GSK-3β), protein kinase B (Akt), mammalian target of rapamycin (mTOR), 70-kDa ribosomal..Investigation of phthalate release from tracheal tubes
Anaesthesia
Dec 2012
Investigation of phthalate release from tracheal tubes
Phthalates are chemicals used extensively in the manufacture of plastics for their desirable physical characteristics. In addition to enhancing the performance of plastics, phthalates have a number of undesirable effects, principally endocrine disruptor effects, that may have adverse effects on reproductive development..The effect of inner tube placement on resistance and work of breathing through tracheostomy tubes: a bench test
Anaesthesia
Dec 2012
The effect of inner tube placement on resistance and work of breathing through tracheostomy tubes: a bench test
To reduce the risk of tracheostomy tube blockage, a removable inner tube can be used. However, this will reduce the size of the lumen and will increase airflow resistance and work of breathing. The magnitude of this increase in workload is unknown. We undertook a bench test to measure the effect. A lung model was..A randomised comparison of variable-frequency automated mandatory boluses with a basal infusion for patient-controlled epidural analgesia during labour and delivery
Anaesthesia
Dec 2012
A randomised comparison of variable-frequency automated mandatory boluses with a basal infusion for patient-controlled epidural analgesia during labour and delivery
This trial was conducted to compare the analgesic efficacy of administering variable-frequency automated boluses at a rate proportional to the patient's needs with fixed continuous basal infusion in patient-controlled epidural analgesia (PCEA) during labour and delivery. We recruited a total of 102 parturients in..A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component
Anaesthesia
Dec 2012
A double-blinded randomised controlled study of the value of sequential intravenous and oral magnesium therapy in patients with chronic low back pain with a neuropathic component
Persistent mechanical irritation of the nerve root sets up a series of events mediating sensitisation of the dorsal roots and dorsal horns in the spinal cord. Current evidence supports the role of magnesium in blocking central sensitisation through its effect on N-methyl–d-aspartate receptors. We studied the role of..Effect of penehyclidine hydrochloride on the incidence of intra-operative awareness in Chinese patients undergoing breast cancer surgery during general anaesthesia
Anaesthesia
Dec 2012
Effect of penehyclidine hydrochloride on the incidence of intra-operative awareness in Chinese patients undergoing breast cancer surgery during general anaesthesia
Intra-operative awareness can lead to serious adverse psychological consequences. We conducted a prospective, randomised, double-blinded trial in 920 patients undergoing breast cancer surgery under bispectral index-guided total intravenous anaesthesia to evaluate the effect of penehyclidine hydrochloride on..Efficacy and safety of intraoperative intravenous methadone during general anaesthesia for caesarean delivery: a retrospective case-control study
International Journal of Obstetric Anesthesia
Dec 2012
Efficacy and safety of intraoperative intravenous methadone during general anaesthesia for caesarean delivery: a retrospective case-control study
Background: Most patients undergoing caesarean delivery with general anaesthesia require systemic opioid administration. Due to its rapid onset and long duration of action, intravenous methadone may make it suitable for analgesia after caesarean delivery. Intraoperative methadone combined with postoperative intravenous..Insertion of an intrathecal catheter following accidental dural puncture: a meta-analysis
International Journal of Obstetric Anesthesia
Dec 2012
Insertion of an intrathecal catheter following accidental dural puncture: a meta-analysis
Background: Inserting an intrathecal catheter after accidental dural puncture in parturients to prevent postdural puncture headache is becoming increasingly popular. We aimed to identify relevant published articles investigating this intervention and subject data to a meta-analysis. Methods: A systematic literature..The impact of spinal anaesthesia for caesarean delivery on coagulation assessed by thromboelastography
International Journal of Obstetric Anesthesia
Nov 2012
The impact of spinal anaesthesia for caesarean delivery on coagulation assessed by thromboelastography
Background: Pregnancy and puerperium are associated with a hypercoagulable state. The aim of the study was to assess the impact of spinal anaesthesia on coagulation using thromboelastography in healthy term pregnant women undergoing elective caesarean delivery. Methods: Thromboelastography was performed on 60 women..A dose–response study of remifentanil for attenuation of the hypertensive response to laryngoscopy and tracheal intubation in severely preeclamptic women undergoing caesarean delivery under general anaesthesia
International Journal of Obstetric Anesthesia
Nov 2012
A dose–response study of remifentanil for attenuation of the hypertensive response to laryngoscopy and tracheal intubation in severely preeclamptic women undergoing caesarean delivery under general anaesthesia
Background: Remifentanil is known to attenuate the cardiovascular responses to tracheal intubation. We determined effective doses (ED50/ED95) of remifentanil to prevent the pressor response to tracheal intubation in patients with severe preeclampsia. Methods: Seventy-five women with severe preeclampsia were randomly..Magnesium and the obstetric anaesthetist
International Journal of Obstetric Anesthesia
Nov 2012
Magnesium and the obstetric anaesthetist
Magnesium is one of the most abundant cations in the human body. It is utilised extensively within the medical world and its role in the treatment of various conditions in both mother and fetus is increasing. This review focuses on the importance of magnesium for the obstetric anaesthetist and looks at the most recent..Changes in End-Tidal Carbon Dioxide and Volumetric Carbon Dioxide as Predictors of Volume Responsiveness in Hemodynamically Unstable Patients
Journal of Cardiothoracic and Vascular Anesthesia
Nov 2012
Changes in End-Tidal Carbon Dioxide and Volumetric Carbon Dioxide as Predictors of Volume Responsiveness in Hemodynamically Unstable Patients
Objective: The purpose of this study was to determine whether changes in PETCO2 and exhaled CO2 (VCO2) can predict fluid responsiveness after a preload challenge. Design: A retrospective review of prospectively recorded data. Setting: A medical intensive care unit of a university-affiliated tertiary care hospital...The effect of pre-procedure anxiety on sedative requirements for sedation during colonoscopy
Anaesthesia
Nov 2012
The effect of pre-procedure anxiety on sedative requirements for sedation during colonoscopy
This study investigated the effects of pre-procedural anxiety (assessed using the Beck Anxiety Inventory) on sedative requirements in 135 patients undergoing sedation for colonoscopy. Deep sedation was defined as loss of consciousness and no response to colonoscopy, and was achieved by target-controlled infusion of..Intrathecal morphine 100 and 200μg for post-cesarean delivery analgesia: a trade-off between analgesic efficacy and side effects
International Journal of Obstetric Anesthesia
Nov 2012
Intrathecal morphine 100 and 200μg for post-cesarean delivery analgesia: a trade-off between analgesic efficacy and side effects
Introduction: Intrathecal morphine is highly effective for post-cesarean analgesia; however, the optimal dose is yet to be established. The aim of this study was to compare analgesia and side effects after a change in institutional practice to give 200μg rather than 100μg. Methods: We conducted a retrospective chart..Hyperfibrinolysis diagnosed by rotational thromboelastometry in a case of suspected amniotic fluid embolism
International Journal of Obstetric Anesthesia
Nov 2012
Hyperfibrinolysis diagnosed by rotational thromboelastometry in a case of suspected amniotic fluid embolism
Rotational thromboelastometry is a viscoelastomeric, point-of-care method for testing haemostasis in whole blood which can be visualised rapidly, in real time, in the operating theatre. Advantages over traditional coagulation tests relate to the rapid feedback of results and the ability to visualise hyperfibrinolysis...Patient-maintained propofol sedation using reaction time monitoring: a volunteer safety study
Anaesthesia
Nov 2012
Patient-maintained propofol sedation using reaction time monitoring: a volunteer safety study
Previous volunteer studies of an effect-site controlled, patient-maintained sedation system using propofol have demonstrated a risk of over-sedation. We have incorporated a reaction-time monitor into the handset of the patient-maintained sedation system to add an individualised patient-feedback mechanism. This study..The effect of propofol on patient reaction time and its relationship with loss of verbal contact before induction of anaesthesia
Anaesthesia
Nov 2012
The effect of propofol on patient reaction time and its relationship with loss of verbal contact before induction of anaesthesia
Increasing the calculated plasma concentration of propofol has been shown to increase choice reaction time and visual and auditory response times. We studied the relationship of reaction to a vibrating handset as the effect-site target-controlled propofol concentration was incrementally increased in 20 patients during..A randomised comparison of InnoScope and Macintosh laryngoscope in simulated difficult tracheal intubation in manikins
Anaesthesia
Nov 2012
A randomised comparison of InnoScope and Macintosh laryngoscope in simulated difficult tracheal intubation in manikins
We conducted a crossover randomised study to evaluate the performance of a novel optical stylet, the InnoScope, for tracheal intubation in simulated normal and difficult airways. Twenty-five anaesthetists attempted tracheal intubation on a SimMan 3G simulator using the InnoScope first followed by the Macintosh..Efficacy and side effects of intravenous remifentanil patient-controlled analgesia used in a stepwise approach for labour: an observational study
International Journal of Obstetric Anesthesia
Nov 2012
Efficacy and side effects of intravenous remifentanil patient-controlled analgesia used in a stepwise approach for labour: an observational study
Background: Remifentanil has a suitable pharmacological profile for labour analgesia. In this prospective, observational study, intravenous patient-controlled analgesia with remifentanil, using stepwise bolus doses without background infusion, was examined during the first and second stages of labour. Outcomes were..The location of paravertebral catheters placed using the landmark technique
Anaesthesia
Nov 2012
The location of paravertebral catheters placed using the landmark technique
The aim of this prospective clinical study was to evaluate the location of paravertebral catheters that were placed using the classical landmark puncture technique and to correlate the distribution of contrast dye injected through the catheters with the extent of somatic block. Paravertebral catheter placement was..Tracheal intubation with a camera embedded in the tube tip (Vivasight™)
Anaesthesia
Nov 2012
Tracheal intubation with a camera embedded in the tube tip (Vivasight™)
We studied tracheal intubation in manikins and patients with a camera embedded in the tip of the tracheal tube (Vivasight™). Four people in two teams and two individuals attempted intubation of a manikin through an i-gel™ 10 times each. The tracheas of 12 patients with a Mallampati grade of 1 were intubated with a..A comparison of clinical practice guidelines for proximal femoral fracture
Anaesthesia
Nov 2012
A comparison of clinical practice guidelines for proximal femoral fracture
Clinical practice guidelines are designed to assist clinical decision-making by summarising evidence and forming recommendations. The number of available guidelines is vast and they vary in relevance and quality. We reviewed guidelines relevant to the management of a patient with a fractured neck of femur and explored..Peripartum outcomes and anaesthetic management of parturients with moderate to complex congenital heart disease or pulmonary hypertension*
Anaesthesia
Nov 2012
Peripartum outcomes and anaesthetic management of parturients with moderate to complex congenital heart disease or pulmonary hypertension*
We performed a retrospective cohort analysis of pregnancies among women with moderate to complex congenital heart disease or pulmonary hypertension over a 12-year period, resulting in a cohort of 107 cases in 65 women. Neuraxial analgesia or anaesthesia was provided in 84%, 89% and 95% of spontaneous vaginal, operative..Arrhythmogenic risk of pulmonary artery catheterisation in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation
Anaesthesia
Nov 2012
Arrhythmogenic risk of pulmonary artery catheterisation in patients with severe aortic stenosis undergoing transcatheter aortic valve implantation
Many clinicians consider severe aortic stenosis to be a contraindication to pulmonary artery catheterisation, except during open heart surgery with cardiopulmonary bypass. This is due to the perceived high risk of arrhythmia, although the true incidence of ventricular tachycardia and fibrillation remains unclear. We..The McGrath® Series 5 videolaryngoscope vs the Macintosh laryngoscope: a randomised, controlled trial in patients with a simulated difficult airway
Anaesthesia
Nov 2012
The McGrath® Series 5 videolaryngoscope vs the Macintosh laryngoscope: a randomised, controlled trial in patients with a simulated difficult airway
We compared the McGrath® Series 5 videolaryngoscope with the Macintosh laryngoscope in a simulated difficult airway, using manual in-line stabilisation in 88 anaesthestised patients of ASA physical status 1-2. The primary outcome was laryngoscopic view. Secondary outcomes included rates of successful tracheal..A review of enhanced recovery for thoracic anaesthesia and surgery
Anaesthesia
Nov 2012
A review of enhanced recovery for thoracic anaesthesia and surgery
During the past decade, there has been a dramatic increase in the number of thoracic surgical procedures carried out in the UK. The current financial climate dictates that more efficient use of resources is necessary to meet escalating demands on healthcare. One potential means to achieve this is through the..The association of pre-operative physical fitness and physical activity with outcome after scheduled major abdominal surgery
Anaesthesia
Nov 2012
The association of pre-operative physical fitness and physical activity with outcome after scheduled major abdominal surgery
We studied whether reported physical activity and measurements of fitness (hand, leg and inspiration) were associated with postoperative in-hospital mortality, length of stay and discharge destination in 169 patients after major oncological abdominal surgery. In multivariate analysis, adequate activity level (OR 5.5,..A randomised controlled trial of dexmedetomidine for suspension laryngoscopy
Anaesthesia
Oct 2012
A randomised controlled trial of dexmedetomidine for suspension laryngoscopy
We randomly allocated 80 patients to intravenous dexmedetomidine (0.25, 0.5, or 1 μg.kg−1) or placebo 15 min before anaesthetic induction. Dexmedetomidine 0.5 and 1.0 μg.kg−1 significantly reduced the mean (95% CI) propofol effect-site concentrations by 0.83 (0.63–1.03) μg.ml−1, p = 0.001 and 1.29 (1.12–1.46) μg.ml−1,..Comparison of peri-operative core temperature in obese and non-obese patients
Anaesthesia
Oct 2012
Comparison of peri-operative core temperature in obese and non-obese patients
Our aim was to compare peri-operative core temperatures and the incidence of hypothermia in obese and non-obese women with active forced-air warming. Twenty female patients scheduled for abdominal surgery were allocated to two groups according to body mass index. Ten obese (30.0–34.9 kg.m−2) and 10 non-obese (18.5–24.9..Effect of table tilt on ligamentum flavum length measured using ultrasonography in pregnant women
Anaesthesia
Oct 2012
Effect of table tilt on ligamentum flavum length measured using ultrasonography in pregnant women
The purpose of this study was to assess whether applying dorsal table tilt to a seated parturient positioned for neuraxial anaesthesia (i.e. facing laterally with her legs over the side of the table) increased the size of the target area for the neuraxial needle. We performed lumbar ultrasonography on 20 pregnant women..Comparison of peri-operative core temperature in obese and non-obese patients
Anaesthesia
Oct 2012
Comparison of peri-operative core temperature in obese and non-obese patients
Our aim was to compare peri-operative core temperatures and the incidence of hypothermia in obese and non-obese women with active forced-air warming. Twenty female patients scheduled for abdominal surgery were allocated to two groups according to body mass index. Ten obese (30.0–34.9 kg.m−2) and 10 non-obese (18.5–24.9..Evaluation of point-of-care haemoglobin measuring devices: a comparison of Radical-7™ pulse co-oximetry, HemoCue® and laboratory haemoglobin measurements in obstetric patients
Anaesthesia
Oct 2012
Evaluation of point-of-care haemoglobin measuring devices: a comparison of Radical-7™ pulse co-oximetry, HemoCue® and laboratory haemoglobin measurements in obstetric patients
We prospectively compared two point-of-care haemoglobin concentration measuring devices with laboratory measurements to determine their accuracy in women undergoing caesarean section delivery. The two devices were the Masimo Rainbow SET® Radical -7™ pulse co-oximeter and the HemoCue® HB 201+, which is a cuvette-type..Effect of propofol on hypoxia re-oxygenation induced neuronal cell damage in vitro
Anaesthesia
Oct 2012
Effect of propofol on hypoxia re-oxygenation induced neuronal cell damage in vitro
Propofol may protect neuronal cells from hypoxia re-oxygenation injury, possibly via an antioxidant actions under hypoxic conditions. This study investigated the molecular effects of propofol on hypoxia-induced cell damage using a neuronal cell line. Cultured human IMR-32 cells were exposed to propofol (30 μm) and..Comparison of the single-use Ambu® aScope™ 2 vs the conventional fibrescope for tracheal intubation in patients with cervical spine immobilisation by a semirigid collar
Anaesthesia
Oct 2012
Comparison of the single-use Ambu® aScope™ 2 vs the conventional fibrescope for tracheal intubation in patients with cervical spine immobilisation by a semirigid collar
Fibreoptic intubation remains a key technique for the management of difficult intubation. We randomly compared the second generation single-use Ambu® aScope™ 2 videoscope with a standard re-usable flexible intubating fibrescope in 50 tracheal intubations in patients with a difficult airway simulated by a semirigid..Assessment of block height for satisfactory spinal anaesthesia for caesarean section
Anaesthesia
Oct 2012
Assessment of block height for satisfactory spinal anaesthesia for caesarean section
We investigated block heights that anaesthetists considered adequate for caesarean section to proceed under spinal anaesthesia. During 3 months, 15 obstetric anaesthetists recorded block height to touch, pinprick or cold when spinal anaesthesia was considered satisfactory for caesarean section to proceed. Median (IQR..Assessment of block height for satisfactory spinal anaesthesia for caesarean section
Anaesthesia
Oct 2012
Assessment of block height for satisfactory spinal anaesthesia for caesarean section
We investigated block heights that anaesthetists considered adequate for caesarean section to proceed under spinal anaesthesia. During 3 months, 15 obstetric anaesthetists recorded block height to touch, pinprick or cold when spinal anaesthesia was considered satisfactory for caesarean section to proceed. Median (IQR..Modified patient-controlled remifentanil bolus delivery regimen for labour pain
Anaesthesia
Oct 2012
Modified patient-controlled remifentanil bolus delivery regimen for labour pain
To improve the analgesic efficiency and to simplify the administration of remifentanil for systemic analgesia in labour, we contrived a modified delivery regimen with a specific infusion profile and variable dosing and conducted a single-blind randomised crossover study to compare it with the previous ‘classical’..The effect of intravenous lidocaine on laryngeal and respiratory reflex responses in anaesthetised children
Anaesthesia
Oct 2012
The effect of intravenous lidocaine on laryngeal and respiratory reflex responses in anaesthetised children
We studied the effect of intravenous lidocaine on laryngeal and respiratory reflex responses in children anaesthetised with sevoflurane. We tested the hypothesis that the incidence of laryngospasm evoked by laryngeal stimulation is temporarily diminished after the administration of lidocaine. Forty children, aged..Comparison of non-invasive and invasive blood pressure in aeromedical care
Anaesthesia
Oct 2012
Comparison of non-invasive and invasive blood pressure in aeromedical care
Blood pressure measurement is an essential physiological measurement for all critically ill patients. Previous work has shown that non-invasive blood pressure is not an accurate reflection of invasive blood pressure measurement. In a transport environment, the effects of motion and vibration may make non-invasive blood..A meta-analysis of magnesium for tetanus
Anaesthesia
Oct 2012
A meta-analysis of magnesium for tetanus
Uncontrolled studies suggest that magnesium sulphate controls spasms in patients with established tetanus. We performed a meta-analysis of controlled trials that compared magnesium sulphate with placebo or diazepam for the treatment of patients with tetanus. We searched PubMed, Scopus, Embase and the Cochrane clinical..Comparison of non-invasive and invasive blood pressure in aeromedical care
Anaesthesia
Oct 2012
Comparison of non-invasive and invasive blood pressure in aeromedical care
Blood pressure measurement is an essential physiological measurement for all critically ill patients. Previous work has shown that non-invasive blood pressure is not an accurate reflection of invasive blood pressure measurement. In a transport environment, the effects of motion and vibration may make non-invasive blood..Changes in the photoplethysmogram with tracheal intubation and remifentanil concentration
Anaesthesia
Sep 2012
Changes in the photoplethysmogram with tracheal intubation and remifentanil concentration
Autonomic sympathetic activation, for instance following noxious stimuli, decreases the size and flattens the shape of the photoplethysmographic peripheral pulse waveform. We report a simple measure of the waveform shape, the ratio of mean-to-peak wave amplitude, for measuring nociception level during general..A randomised crossover trial comparing a single-use polyvinyl chloride laryngeal mask airway with a single-use silicone laryngeal mask airway
Anaesthesia
Sep 2012
A randomised crossover trial comparing a single-use polyvinyl chloride laryngeal mask airway with a single-use silicone laryngeal mask airway
We compared insertion rates of single-use polyvinyl chloride laryngeal mask airways (LMAs) vs single-use silicone LMAs in 72 anaesthetised patients. Both airways were produced by Flexicare Medical. Laryngeal mask airway insertion was successful on the first attempt in 68/72 (94%) polyvinyl chloride LMAs vs 64/72 (89%)..Closed-loop double-vasopressor automated system to treat hypotension during spinal anaesthesia for caesarean section: a preliminary study
Anaesthesia
Sep 2012
Closed-loop double-vasopressor automated system to treat hypotension during spinal anaesthesia for caesarean section: a preliminary study
Hypotension occurs in most caesarean sections under spinal anaesthesia, necessitating vasopressor administration. However, the optimal dosing regimen remains unclear. We have developed a novel vasopressor delivery system that automatically administers phenylephrine or ephedrine based on continuous non-invasive blood..A comparison of the pelvic angle applied using lateral table tilt or a pelvic wedge at elective caesarean section
Anaesthesia
Sep 2012
A comparison of the pelvic angle applied using lateral table tilt or a pelvic wedge at elective caesarean section
Lateral table tilt or a pelvic wedge are commonly used to reduce inferior vena cava compression during obstetric anaesthesia in the supine position. Direct measurement of pelvic angle allows individual assessment of the effectiveness of these manoeuvres in achieving a tilted position. We observed routine practice..A comparison of the pelvic angle applied using lateral table tilt or a pelvic wedge at elective caesarean section
Anaesthesia
Sep 2012
A comparison of the pelvic angle applied using lateral table tilt or a pelvic wedge at elective caesarean section
Lateral table tilt or a pelvic wedge are commonly used to reduce inferior vena cava compression during obstetric anaesthesia in the supine position. Direct measurement of pelvic angle allows individual assessment of the effectiveness of these manoeuvres in achieving a tilted position. We observed routine practice..The impact on cardiac diagnosis and mortality of focused transthoracic echocardiography in hip fracture surgery patients with increased risk of cardiac disease: a retrospective cohort study
Anaesthesia
Sep 2012
The impact on cardiac diagnosis and mortality of focused transthoracic echocardiography in hip fracture surgery patients with increased risk of cardiac disease: a retrospective cohort study
Hip fracture surgery is associated with a high rate of mortality and morbidity; heart disease is the leading cause and is often unrecognised and inadequately treated. Pre-operative focused transthoracic echocardiography by anaesthetists frequently influences management, but mortality outcome studies have not been..A randomised comparison of two intranasal dexmedetomidine doses for premedication in children
Anaesthesia
Sep 2012
A randomised comparison of two intranasal dexmedetomidine doses for premedication in children
We compared sedation levels in children following administration of intranasal dexmedetomidine. One hundred and sixteen children aged between 1 and 8 years were enrolled in this prospective, randomised trial. Children were assigned to receive either intranasal dexmedetomidine 1 μg.kg−1 (Group 1) or 2 μg.kg−1 (Group 2)...A randomised comparison of two intranasal dexmedetomidine doses for premedication in children
Anaesthesia
Sep 2012
A randomised comparison of two intranasal dexmedetomidine doses for premedication in children
We compared sedation levels in children following administration of intranasal dexmedetomidine. One hundred and sixteen children aged between 1 and 8 years were enrolled in this prospective, randomised trial. Children were assigned to receive either intranasal dexmedetomidine 1 μg.kg−1 (Group 1) or 2 μg.kg−1 (Group 2)...The impact on cardiac diagnosis and mortality of focused transthoracic echocardiography in hip fracture surgery patients with increased risk of cardiac disease: a retrospective cohort study
Anaesthesia
Sep 2012
The impact on cardiac diagnosis and mortality of focused transthoracic echocardiography in hip fracture surgery patients with increased risk of cardiac disease: a retrospective cohort study
Hip fracture surgery is associated with a high rate of mortality and morbidity; heart disease is the leading cause and is often unrecognised and inadequately treated. Pre-operative focused transthoracic echocardiography by anaesthetists frequently influences management, but mortality outcome studies have not been..A comparison of intra-operative blood loss and acid–base balance between vasopressor and inotrope strategy during living donor liver transplantation: a randomised, controlled study
Anaesthesia
Sep 2012
A comparison of intra-operative blood loss and acid–base balance between vasopressor and inotrope strategy during living donor liver transplantation: a randomised, controlled study
Administration of vasopressors or inotropes during liver transplant surgery is almost universal, as this procedure is often accompanied by massive haemorrhage, acid–base imbalance, and cardiovascular instability. However, the actual agents that should be used and the choice between a vasopressor and an inotrope..A meta-analysis of the accuracy and precision of the ultrasonic cardiac output monitor (USCOM)
Anaesthesia
Aug 2012
A meta-analysis of the accuracy and precision of the ultrasonic cardiac output monitor (USCOM)
The ultrasonic cardiac output monitor is a non-invasive, continuous-wave Doppler monitor that can be used to measure cardiac output. Its accuracy and precision in peri-operative and critical care has been assessed with varied results. We conducted a meta-analysis to calculate a pooled mean bias, precision and..A clinical evaluation of four non-Luer spinal needle and syringe systems
Anaesthesia
Aug 2012
A clinical evaluation of four non-Luer spinal needle and syringe systems
We performed an evaluation of non-Luer spinal devices supplied by four manufacturers or suppliers: Polymedic; Pajunk; Sarstedt; and Smiths. For each supplier, 100 evaluations were performed using a 25-G 90-mm spinal needle, 3-ml syringe, 5-ml syringe and filter needle; for comparison, 100 evaluations were performed..The effect of beta-2 adrenergic receptor haplotype variations on the haemodynamic response following spinal anaesthesia for caesarean delivery
Anaesthesia
Aug 2012
The effect of beta-2 adrenergic receptor haplotype variations on the haemodynamic response following spinal anaesthesia for caesarean delivery
We investigated whether genetic variations of the beta-2 adrenergic receptor (ADRB2) modulate the haemodynamic response following spinal anaesthesia for caesarean delivery. We focused on the effects of haplotypes formed by combinations of the Arg16Gly and Gln27Glu polymorphisms. Clinical data from 143 healthy..The effect of a cervical collar on the seal pressure of the LMA Supreme™: a prospective, crossover trial
Anaesthesia
Aug 2012
The effect of a cervical collar on the seal pressure of the LMA Supreme™: a prospective, crossover trial
For personnel inexperienced in airway management, supraglottic airway devices may be the first choice in an emergency. Changing head position is known to reduce the seal pressure of a laryngeal mask airway. The aim of this study was to investigate whether the use of a cervical collar improves the stability of airways..A clinical evaluation of four non-Luer spinal needle and syringe systems
Anaesthesia
Aug 2012
A clinical evaluation of four non-Luer spinal needle and syringe systems
We performed an evaluation of non-Luer spinal devices supplied by four manufacturers or suppliers: Polymedic; Pajunk; Sarstedt; and Smiths. For each supplier, 100 evaluations were performed using a 25-G 90-mm spinal needle, 3-ml syringe, 5-ml syringe and filter needle; for comparison, 100 evaluations were performed..The effect of beta-2 adrenergic receptor haplotype variations on the haemodynamic response following spinal anaesthesia for caesarean delivery
Anaesthesia
Aug 2012
The effect of beta-2 adrenergic receptor haplotype variations on the haemodynamic response following spinal anaesthesia for caesarean delivery
We investigated whether genetic variations of the beta-2 adrenergic receptor (ADRB2) modulate the haemodynamic response following spinal anaesthesia for caesarean delivery. We focused on the effects of haplotypes formed by combinations of the Arg16Gly and Gln27Glu polymorphisms. Clinical data from 143 healthy..The effect of a cervical collar on the seal pressure of the LMA Supreme™: a prospective, crossover trial
Anaesthesia
Aug 2012
The effect of a cervical collar on the seal pressure of the LMA Supreme™: a prospective, crossover trial
For personnel inexperienced in airway management, supraglottic airway devices may be the first choice in an emergency. Changing head position is known to reduce the seal pressure of a laryngeal mask airway. The aim of this study was to investigate whether the use of a cervical collar improves the stability of airways..Effect of hyperoxia and vascular occlusion on tissue oxygenation measured by near infra-red spectroscopy (InSpectra™): a volunteer study
Anaesthesia
Aug 2012
Effect of hyperoxia and vascular occlusion on tissue oxygenation measured by near infra-red spectroscopy (InSpectra™): a volunteer study
Standard cardiorespiratory monitoring may fail to detect occult tissue ischaemia. This study assessed whether a near infra-red spectroscopy tissue oxygen saturation monitor (InSpectra™) could detect progressive peripheral tissue ischaemia and whether hyperoxia may confound tissue oxygen saturation measurement. Tissue..Effect of hyperoxia and vascular occlusion on tissue oxygenation measured by near infra-red spectroscopy (InSpectra™): a volunteer study
Anaesthesia
Aug 2012
Effect of hyperoxia and vascular occlusion on tissue oxygenation measured by near infra-red spectroscopy (InSpectra™): a volunteer study
Standard cardiorespiratory monitoring may fail to detect occult tissue ischaemia. This study assessed whether a near infra-red spectroscopy tissue oxygen saturation monitor (InSpectra™) could detect progressive peripheral tissue ischaemia and whether hyperoxia may confound tissue oxygen saturation measurement. Tissue..Usability testing of a prototype Phone Oximeter with healthcare providers in high- and low-medical resource environments
Anaesthesia
Aug 2012
Usability testing of a prototype Phone Oximeter with healthcare providers in high- and low-medical resource environments
To increase the use of pulse oximetry by capitalise on the wide availability of mobile phones, we have designed, developed and evaluated a prototype pulse oximeter interfaced to a mobile phone. Usability of this Phone Oximeter was tested as part of a rapid prototyping process. Phase 1 of the study (20 subjects) was..Evaluation of the CEL-100 videolaryngoscopeTM for double-lumen tracheal tube insertion after failure using the Macintosh laryngoscope
Anaesthesia
Jul 2012
Evaluation of the CEL-100 videolaryngoscopeTM for double-lumen tracheal tube insertion after failure using the Macintosh laryngoscope
We prospectively evaluated the CEL-100 videolaryngoscopeTM for insertion of double-lumen tracheal tubes in 48 consecutive patients who had been found to have an unanticipated Cormack and Lehane grade 3 (n = 43) and grade 4 (n = 5) laryngeal view and in whom two attempts at tracheal intubation using the Macintosh..Pharmacokinetics of tranexamic acid in patients undergoing cardiac surgery with use of cardiopulmonary bypass
Anaesthesia
Jul 2012
Pharmacokinetics of tranexamic acid in patients undergoing cardiac surgery with use of cardiopulmonary bypass
We conducted a study to assess pharmacokinetics of high-dose tranexamic acid for 24 h after administration of the drug in patients undergoing cardiac surgery with cardiopulmonary bypass. High-dose tranexamic acid involved a bolus of 30 mg.kg−1 infused over 15 min followed by a 16 mg.kg−1.h−1 infusion until chest..Effects of sugammadex and rocuronium mast cell number and degranulation in rat liver
Anaesthesia
Jul 2012
Effects of sugammadex and rocuronium mast cell number and degranulation in rat liver
We investigated the effect of rocuronium- and sugammadex-induced mast cell increase and degranulation in rat portal triads. Forty-two rats, in six groups, received either rocuronium 1 mg.kg−1; sugammadex 15 mg.kg−1; sugammadex 100 mg.kg−1; rocuronium 1 mg.kg−1 and 5 min later, sugammadex 15 mg.kg−1; rocuronium 1..Pharmacokinetics of tranexamic acid in patients undergoing cardiac surgery with use of cardiopulmonary bypass
Anaesthesia
Jul 2012
Pharmacokinetics of tranexamic acid in patients undergoing cardiac surgery with use of cardiopulmonary bypass
We conducted a study to assess pharmacokinetics of high-dose tranexamic acid for 24 h after administration of the drug in patients undergoing cardiac surgery with cardiopulmonary bypass. High-dose tranexamic acid involved a bolus of 30 mg.kg−1 infused over 15 min followed by a 16 mg.kg−1.h−1 infusion until chest..Evaluation of the CEL-100 videolaryngoscopeTM for double-lumen tracheal tube insertion after failure using the Macintosh laryngoscope
Anaesthesia
Jul 2012
Evaluation of the CEL-100 videolaryngoscopeTM for double-lumen tracheal tube insertion after failure using the Macintosh laryngoscope
We prospectively evaluated the CEL-100 videolaryngoscopeTM for insertion of double-lumen tracheal tubes in 48 consecutive patients who had been found to have an unanticipated Cormack and Lehane grade 3 (n = 43) and grade 4 (n = 5) laryngeal view and in whom two attempts at tracheal intubation using the Macintosh..The pre-emptive analgesic effect of a cyclooxygenase-2 inhibitor in a rat model of acute postoperative pain
Anaesthesia
Jul 2012
The pre-emptive analgesic effect of a cyclooxygenase-2 inhibitor in a rat model of acute postoperative pain
We examined the pre-emptive analgesic effect of a cyclooxygenase (COX)-2 inhibitor in a rat surgical pain model and characterised the changes in cutaneous COX-2 around a surgical site. Thermal hyperalgesia and mechanical allodynia were tested in the rats for three days after incision and skin tissues were collected for..Platelet mapping as part of modified thromboelastography (TEG®) in patients undergoing cardiac surgery and cardiopulmonary bypass
Anaesthesia
Jul 2012
Platelet mapping as part of modified thromboelastography (TEG®) in patients undergoing cardiac surgery and cardiopulmonary bypass
The platelet-mapping assay of the thromboelastograph was used to measure platelet aggregation and to examine the effect of cardiopulmonary bypass on multiple platelet receptors and the role of altered receptor activity in postoperative bleeding. The percentage platelet aggregation for collagen, adenosine diphosphate..A multicentre observational study of intra-operative ventilatory management during general anaesthesia: tidal volumes and relation to body weight
Anaesthesia
Jul 2012
A multicentre observational study of intra-operative ventilatory management during general anaesthesia: tidal volumes and relation to body weight
We conducted an observational prospective multicenter study to describe the practices of mechanical ventilation, to determine the incidence of use of large intra-operative tidal volumes (≥ 10 ml.kg−1 of ideal body weight) and to identify patient factors associated with this practice. Of the 2960 patients studied in 97..An evaluation of the ability of leucocyte depletion filters to remove components of amniotic fluid
Anaesthesia
Jul 2012
An evaluation of the ability of leucocyte depletion filters to remove components of amniotic fluid
Haemorrhage remains an important cause of maternal mortality worldwide. Cell salvage carries a theoretical risk of amniotic fluid embolus syndrome and is too expensive for use in many parts of the world. To explore cheaper options, we investigated whether a leucocyte depletion filter alone removes components of pure..Epidural catheter connectors: a laboratory-based comparison of the Portex Tuohy-Borst and EpiFuse™ designs
Anaesthesia
Jul 2012
Epidural catheter connectors: a laboratory-based comparison of the Portex Tuohy-Borst and EpiFuse™ designs
Disconnection of an epidural catheter from its connector may result in patient harm and commonly requires resiting of the epidural. Clamp-connector designs such as the novel Portex EpiFuse™ potentially offer an improved safety profile over screw-cap designs such as the Tuohy-Borst, but comparative studies are limited...A national service evaluation of the impact of alcohol on admissions to Scottish intensive care units
Anaesthesia
Jul 2012
A national service evaluation of the impact of alcohol on admissions to Scottish intensive care units
Alcohol-related disease adversely affects the outcome of critically ill patients. The burden of this in Scotland is higher than elsewhere in the United Kingdom. In a prospective observational study of all patients admitted to the 24 intensive care units in Scotland we assessed the proportion of admissions in which..Evaluation of radial and ulnar blood flow after radial artery cannulation with 20- and 22-gauge cannulae using duplex Doppler ultrasound
Anaesthesia
Jul 2012
Evaluation of radial and ulnar blood flow after radial artery cannulation with 20- and 22-gauge cannulae using duplex Doppler ultrasound
This study evaluated ulnar and radial artery blood flow after radial artery cannulation during general anaesthesia using Doppler ultrasound. A total of 80 patients were randomly assigned to receive radial artery cannulation with either a 20-G or 22-G cannula. Arterial diameter, peak systolic velocity, end-diastolic..Modulation of pain sensation by stress-related testosterone and cortisol
Anaesthesia
Jul 2012
Modulation of pain sensation by stress-related testosterone and cortisol
Stress increases cortisol and decreases testosterone. It is not known whether pain is affected by stress-related testosterone. Therefore, we investigated whether stress can affect pain perception by decreasing testosterone and increasing cortisol. Pain thresholds, pain and anxiety ratings and salivary testosterone and..The effect of the European Working Time Directive on anaesthetic working patterns and training
Anaesthesia
Jul 2012
The effect of the European Working Time Directive on anaesthetic working patterns and training
There is concern that the European Working Time Directive 2009 has led to reduced time available for training, and this study examined if this has been the case. For two identical six-month periods in 1999 (pre-Directive) and 2009 (post-Directive), weekly data were collected on the total number of sessions attended by..A national service evaluation of the impact of alcohol on admissions to Scottish intensive care units
Anaesthesia
Jul 2012
A national service evaluation of the impact of alcohol on admissions to Scottish intensive care units
Alcohol-related disease adversely affects the outcome of critically ill patients. The burden of this in Scotland is higher than elsewhere in the United Kingdom. In a prospective observational study of all patients admitted to the 24 intensive care units in Scotland we assessed the proportion of admissions in which..The effect of the European Working Time Directive on anaesthetic working patterns and training
Anaesthesia
Jul 2012
The effect of the European Working Time Directive on anaesthetic working patterns and training
There is concern that the European Working Time Directive 2009 has led to reduced time available for training, and this study examined if this has been the case. For two identical six-month periods in 1999 (pre-Directive) and 2009 (post-Directive), weekly data were collected on the total number of sessions attended by..Modulation of pain sensation by stress-related testosterone and cortisol
Anaesthesia
Jul 2012
Modulation of pain sensation by stress-related testosterone and cortisol
Stress increases cortisol and decreases testosterone. It is not known whether pain is affected by stress-related testosterone. Therefore, we investigated whether stress can affect pain perception by decreasing testosterone and increasing cortisol. Pain thresholds, pain and anxiety ratings and salivary testosterone and..Epidural catheter connectors: a laboratory-based comparison of the Portex Tuohy-Borst and EpiFuse™ designs
Anaesthesia
Jul 2012
Epidural catheter connectors: a laboratory-based comparison of the Portex Tuohy-Borst and EpiFuse™ designs
Disconnection of an epidural catheter from its connector may result in patient harm and commonly requires resiting of the epidural. Clamp-connector designs such as the novel Portex EpiFuse™ potentially offer an improved safety profile over screw-cap designs such as the Tuohy-Borst, but comparative studies are limited...Evaluation of radial and ulnar blood flow after radial artery cannulation with 20- and 22-gauge cannulae using duplex Doppler ultrasound
Anaesthesia
Jul 2012
Evaluation of radial and ulnar blood flow after radial artery cannulation with 20- and 22-gauge cannulae using duplex Doppler ultrasound
This study evaluated ulnar and radial artery blood flow after radial artery cannulation during general anaesthesia using Doppler ultrasound. A total of 80 patients were randomly assigned to receive radial artery cannulation with either a 20-G or 22-G cannula. Arterial diameter, peak systolic velocity, end-diastolic..A randomised controlled trial comparing sugammadex and neostigmine at different depths of neuromuscular blockade in patients undergoing laparoscopic surgery
Anaesthesia
Jul 2012
A randomised controlled trial comparing sugammadex and neostigmine at different depths of neuromuscular blockade in patients undergoing laparoscopic surgery
Deep neuromuscular blockade during certain surgical procedures may improve operating conditions. Sugammadex can be used to reverse deep neuromuscular blockade without waiting for spontaneous recovery. This randomised study compared recovery times from neuromuscular blockade induced by rocuronium 0.6 mg.kg−1, using..The Inflammatory Response to Cardiac Surgery With Cardiopulmonary Bypass: Should Steroid Prophylaxis Be Routine?
Journal of Cardiothoracic and Vascular Anesthesia
Jul 2012
The Inflammatory Response to Cardiac Surgery With Cardiopulmonary Bypass: Should Steroid Prophylaxis Be Routine?
Cardiac surgery with cardiopulmonary bypass (CPB) triggers a vigorous systemic inflammatory response characterized by early and late phases involving both the humoral and cellular pathways. Steroids dampen the immune response to CPB in a multimodal fashion. Perioperative steroid prophylaxis offers the possibility to..Increased Left Ventricular Myocardial Mass Is Associated With Arrhythmias After Cardiac Surgery
Journal of Cardiothoracic and Vascular Anesthesia
Jul 2012
Increased Left Ventricular Myocardial Mass Is Associated With Arrhythmias After Cardiac Surgery
Objectives: The purpose of this study was to investigate whether patients with an elevated left ventricular mass index undergoing cardiac surgery were more likely to experience postoperative atrial and ventricular arrhythmias. Design: A retrospective analysis. Setting: A single tertiary care university hospital...Evaluation of the Neuroprotective Effect of Minocycline in a Rabbit Spinal Cord Ischemia Model
Journal of Cardiothoracic and Vascular Anesthesia
Jul 2012
Evaluation of the Neuroprotective Effect of Minocycline in a Rabbit Spinal Cord Ischemia Model
Objective: To investigate whether postischemic administration of minocycline attenuates hind-limb motor dysfunction and gray and white matter injuries after spinal cord ischemia. Design: A prospective, randomized, laboratory investigation. Setting: Laboratory in university, single institution. Participants: Male New..The effect of combined spinal-epidural anesthesia versus general anesthesia on the recovery time of intestinal function in young infants undergoing intestinal surgery: a randomized, prospective, controlled trial
Journal of Clinical Anesthesia
Jul 2012
The effect of combined spinal-epidural anesthesia versus general anesthesia on the recovery time of intestinal function in young infants undergoing intestinal surgery: a randomized, prospective, controlled trial
Study Objective: To assess the rate of restoration of gastrointestinal (GI) function following combined spinal-epidural (CSE) anesthesia compared with general anesthesia in young infants undergoing elective intestinal surgery. Design: Prospective, randomized, controlled study. Setting: Operating room and neonatal..Prevention of pain on injection of rocuronium: a comparison of lidocaine with different doses of parecoxib
Journal of Clinical Anesthesia
Jul 2012
Prevention of pain on injection of rocuronium: a comparison of lidocaine with different doses of parecoxib
Study Objective: To compare the efficacy of pretreatment with parecoxib and lidocaine to prevent rocuronium injection pain. Design: Prospective, randomized, double-blinded study. Setting: Academic medical center. Patients: 160 adult ASA physical status 1 and 2 patients scheduled for elective surgery. Interventions:..Scheduled perioperative switch from oral sildenafil to intravenous epoprostenol in a patient with Eisenmenger syndrome undergoing a sigmoidectomy
Journal of Clinical Anesthesia
Jul 2012
Scheduled perioperative switch from oral sildenafil to intravenous epoprostenol in a patient with Eisenmenger syndrome undergoing a sigmoidectomy
The perioperative management of pulmonary hypertension in a patient with Eisenmenger syndrome, the most advanced form of associated pulmonary artery hypertension (PAH), who required a sigmoidectomy is presented. The treatment for pulmonary hypertension was switched from oral sildenafil to intravenous epoprostenol to..A meta-analysis of prevention of postoperative nausea and vomiting: randomised controlled trials by Fujii et al. compared with other authors
Anaesthesia
Jun 2012
A meta-analysis of prevention of postoperative nausea and vomiting: randomised controlled trials by Fujii et al. compared with other authors
The population sampling in randomised controlled trials by Fujii et al. have been shown to exhibit unusual distributions. This systematic review analysed the effectiveness of prophylactic antiemetics in trials by Fujii et al. compared with other authors. Granisetron was more effective in trials by Fujii et al.,..Quantitative analysis of changes in blood concentrations and ‘presumed effect-site concentration’ of sevoflurane during one-lung ventilation
Anaesthesia
Jun 2012
Quantitative analysis of changes in blood concentrations and ‘presumed effect-site concentration’ of sevoflurane during one-lung ventilation
During one-lung ventilation, ventilation-perfusion mismatch decreases the arterial concentration of inhaled anaesthetics due to the arterial-to-venous concentration difference. This study tested the hypothesis that in humans, the ‘presumed effect-site concentration’ (taken as the mid-point between the arterial and..Haemodynamics in women with untreated pre-eclampsia
Anaesthesia
Jun 2012
Haemodynamics in women with untreated pre-eclampsia
This study aimed to compare the haemodynamics in healthy pregnant women with the haemodynamics in women with untreated pre-eclampsia, to determine the cardiovascular reason for hypertension in pre-eclampsia. 40 women with untreated pre-eclampsia, 40 matched healthy pregnant women and 20 non-pregnant women were studied..Haemodynamics in women with untreated pre-eclampsia
Anaesthesia
Jun 2012
Haemodynamics in women with untreated pre-eclampsia
This study aimed to compare the haemodynamics in healthy pregnant women with the haemodynamics in women with untreated pre-eclampsia, to determine the cardiovascular reason for hypertension in pre-eclampsia. 40 women with untreated pre-eclampsia, 40 matched healthy pregnant women and 20 non-pregnant women were studied..Randomized Evidence for Reduction of Perioperative Mortality
Journal of Cardiothoracic and Vascular Anesthesia
Jun 2012
Randomized Evidence for Reduction of Perioperative Mortality
Objective: With more than 220 million major surgical procedures performed annually, perioperative interventions leading to even minor mortality reductions would save thousands of lives per year. This international consensus conference aimed to identify all nonsurgical interventions that increase or reduce perioperative..A multicentre observational study of intra-operative ventilatory management during general anaesthesia: tidal volumes and relation to body weight
Anaesthesia
Jun 2012
A multicentre observational study of intra-operative ventilatory management during general anaesthesia: tidal volumes and relation to body weight
We conducted an observational prospective multicenter study to describe the practices of mechanical ventilation, to determine the incidence of use of large intra-operative tidal volumes (≥ 10 ml.kg−1 of ideal body weight) and to identify patient factors associated with this practice. Of the 2960 patients studied in 97..A randomised controlled trial comparing sugammadex and neostigmine at different depths of neuromuscular blockade in patients undergoing laparoscopic surgery
Anaesthesia
Jun 2012
A randomised controlled trial comparing sugammadex and neostigmine at different depths of neuromuscular blockade in patients undergoing laparoscopic surgery
Deep neuromuscular blockade during certain surgical procedures may improve operating conditions. Sugammadex can be used to reverse deep neuromuscular blockade without waiting for spontaneous recovery. This randomised study compared recovery times from neuromuscular blockade induced by rocuronium 0.6 mg.kg−1, using..A randomised controlled trial comparing sugammadex and neostigmine at different depths of neuromuscular blockade in patients undergoing laparoscopic surgery
Anaesthesia
Jun 2012
A randomised controlled trial comparing sugammadex and neostigmine at different depths of neuromuscular blockade in patients undergoing laparoscopic surgery
Deep neuromuscular blockade during certain surgical procedures may improve operating conditions. Sugammadex can be used to reverse deep neuromuscular blockade without waiting for spontaneous recovery. This randomised study compared recovery times from neuromuscular blockade induced by rocuronium 0.6 mg.kg−1, using..A randomised controlled trial comparing two insertion techniques for the Laryngeal Mask Airway Flexible™ in patients undergoing dental surgery
Anaesthesia
Jun 2012
A randomised controlled trial comparing two insertion techniques for the Laryngeal Mask Airway Flexible™ in patients undergoing dental surgery
The Laryngeal Mask Airway FlexibleTM (LMA Flexible) has been widely utilised for dental, ophthalmology and otorhinolaryngology-related procedures. Our study evaluates two different techniques of inserting the LMA Flexible for patients undergoing day-case dental surgery. One hundred and eight patients were randomly..A new technique for percutaneous dilatational tracheostomy (G-Trach): preliminary experience in pigs
Anaesthesia
Jun 2012
A new technique for percutaneous dilatational tracheostomy (G-Trach): preliminary experience in pigs
Tracheostomies are currently used for airway management in patients requiring long-term respiratory assistance. The dilatational percutaneous technique of forming tracheostomies is a valuable alternative to traditional surgical ‘open’ techniques. In this study, we tested a new dilatational percutaneous tracheostomy..A randomised comparison of the self-pressurised air-QTM intubating laryngeal airway with the LMA UniqueTM in children*
Anaesthesia
Jun 2012
A randomised comparison of the self-pressurised air-QTM intubating laryngeal airway with the LMA UniqueTM in children*
We conducted a randomised trial comparing the self-pressurised air-QTM intubating laryngeal airway (air-Q SP) with the LMA-Unique in 60 children undergoing surgery. Outcomes measured were airway leak pressure, ease and time for insertion, fibreoptic examination, incidence of gastric insufflation and complications...Comparison of Macintosh and AirtraqTM laryngoscopes in obese patients placed in the ramped position
Anaesthesia
Jun 2012
Comparison of Macintosh and AirtraqTM laryngoscopes in obese patients placed in the ramped position
This study compared intubation conditions produced by the Macintosh and AirtraqTM laryngoscopes when used in obese patients in the ramped position. One hundred and thirty-two patients having bariatric surgery were placed in the ramped position and randomly assigned to have their tracheas intubated using either the..Effect of positioning from supine and left lateral positions to left lateral tilt on maternal blood flow velocities and waveforms in full-term parturients
Anaesthesia
May 2012
Effect of positioning from supine and left lateral positions to left lateral tilt on maternal blood flow velocities and waveforms in full-term parturients
Positioning the parturient from supine to the left lateral tilt position (supine-to-tilt) may not effectively displace the gravid uterus, but turning from the left lateral position to the left lateral tilt position (left lateral-to-tilt) may keep the gravid uterus displaced and prevent aortocaval compression. Fifty-one..Anaphylaxis admissions to UK critical care units between 2005 and 2009
Anaesthesia
May 2012
Anaphylaxis admissions to UK critical care units between 2005 and 2009
Anaphylaxis is a life-threatening emergency that may necessitate admission to a critical care unit. There are no reports of the frequency of admission to critical care units for patients with anaphylaxis or indeed any description of their demographic characteristics or outcomes. We analysed all physician-diagnosed..Removal of the stylet from the tracheal tube: effect of lubrication
Anaesthesia
May 2012
Removal of the stylet from the tracheal tube: effect of lubrication
We compared the work needed to retract a non-lubricated and a lubricated stylet from a tracheal tube over 24 h. Stylets were lubricated with sterile water, silicone fluid, lidocaine spray, lidocaine gel, MedPro® lubricating gel or Lacri-Lube®. The mean (SD) work in joules needed to retract the stylet by 5 cm from the..Utility of Nociceptive Flexion Reflex Threshold, Bispectral Index, Composite Variability Index and Noxious Stimulation Response Index as measures for nociception during general anaesthesia
Anaesthesia
May 2012
Utility of Nociceptive Flexion Reflex Threshold, Bispectral Index, Composite Variability Index and Noxious Stimulation Response Index as measures for nociception during general anaesthesia
Movement and haemodynamic responses to noxious stimuli during general anaesthesia are regarded as signs of nociception. We compared the Nociceptive Flexion Reflex Threshold (NFRT), Bispectral Index (BIS), Composite Variability Index (CVI), Noxious Stimulation Response Index (NSRI) and the calculated..Extended release formulations for local anaesthetic agents
Anaesthesia
May 2012
Extended release formulations for local anaesthetic agents
Systemic toxicity through overdose of local anaesthetic agents is a real concern. By encapsulating local anaesthetics in biodegradable carriers to produce a system for prolonged release, their duration of action can be extended. This encapsulation should also improve the safety profile of the local anaesthetic as it is..Use of the pre-operative shuttle walk test to predict morbidity and mortality after elective major colorectal surgery
Anaesthesia
May 2012
Use of the pre-operative shuttle walk test to predict morbidity and mortality after elective major colorectal surgery
High-risk surgery is performed in every acute hospital. These patients often have increased peri-operative risk related to their poor cardiorespiratory reserve. Formal risk assessment is recommended for such patients; cardiopulmonary exercise testing is a well established triage tool, but is unavailable in many..Fluid balance monitoring by cuff-occluded rate of rise of peripheral venous pressure in haemodialysis patients
Anaesthesia
May 2012
Fluid balance monitoring by cuff-occluded rate of rise of peripheral venous pressure in haemodialysis patients
Cuff-occluded rate of rise of peripheral venous pressure has been proposed to reflect volume changes in experimental studies. The aim of this study was to evaluate changes in cuff-occluded rate of rise of peripheral venous pressure associated with fluid removal by haemodialysis in six adult patients with chronic renal..Effects of magnesium sulphate on postoperative coagulation, measured by rotational thromboelastometry (ROTEM®)*
Anaesthesia
Apr 2012
Effects of magnesium sulphate on postoperative coagulation, measured by rotational thromboelastometry (ROTEM®)*
We investigated the effects of magnesium sulphate on blood coagulation profiles using rotational thromboelastometry in gynaecological patients undergoing pelviscopic surgery. Patients were randomly allocated to the magnesium group (n = 20) or control group (n = 20). The magnesium group received magnesium sulphate..Closed and open breathing circuit function in healthy volunteers during exercise at Mount Everest base camp (5300 m)
Anaesthesia
Apr 2012
Closed and open breathing circuit function in healthy volunteers during exercise at Mount Everest base camp (5300 m)
We present a randomised, controlled, crossover trial of the Caudwell Xtreme Everest (CXE) closed circuit breathing system vs an open circuit and ambient air control in six healthy, hypoxic volunteers at rest and exercise at Everest Base Camp, at 5300 m. Compared with control, arterial oxygen saturations were improved..Is ‘starting on time’ useful (or useless) as a surrogate measure for ‘surgical theatre efficiency’?
Anaesthesia
Apr 2012
Is ‘starting on time’ useful (or useless) as a surrogate measure for ‘surgical theatre efficiency’?
We analysed more than 7000 theatre lists from two similar UK hospitals, to assess whether start times and finish times were correlated. We also analysed gap times (the time between patients when no anaesthesia or surgery occurs), to see whether these affected theatre efficiency. Operating list start and finish times..Novice performance of ultrasound-guided needle advancement: standard 38-mm transducer vs 25-mm hockey stick transducer
Anaesthesia
Apr 2012
Novice performance of ultrasound-guided needle advancement: standard 38-mm transducer vs 25-mm hockey stick transducer
The optimal method to develop expertise in ultrasound-guided regional anaesthesia is unknown. Studies of laryngoscopic expertise in novices demonstrate that the choice of laryngoscope affects performance. In this study, we aimed to compare the effect of two different linear array transducers (38-mm standard vs 25-mm..Evaluation of a new analyser for rapid measurement of blood propofol concentration during cardiac surgery
Anaesthesia
Apr 2012
Evaluation of a new analyser for rapid measurement of blood propofol concentration during cardiac surgery
We report laboratory and clinical evaluations of a blood propofol concentration analyser. Laboratory experiments used volunteer blood spiked with known propofol concentrations over the clinically relevant concentrations from 0.5 to 16 μg.ml−1 to assess linearity and the influence of haematocrit and concurrent drug..A comparison of the Pentax Airway Scope™ with the Airtraq™ in an infant manikin
Anaesthesia
Apr 2012
A comparison of the Pentax Airway Scope™ with the Airtraq™ in an infant manikin
We compared the Pentax Airway ScopeTM with the AirtraqTM optical laryngoscope in an infant manikin. Twenty-three anaesthetists randomly performed tracheal intubation: at rest, (a) with the Airway Scope and (b) with the Airtraq; and during chest compressions, (c) with the Airway Scope and (d) with the Airtraq. The..Parasternal Intercostal Block With Ropivacaine for Postoperative Analgesia in Pediatric Patients Undergoing Cardiac Surgery: A Double-Blind, Randomized, Controlled Study
Journal of Cardiothoracic and Vascular Anesthesia
Dec 2011
Parasternal Intercostal Block With Ropivacaine for Postoperative Analgesia in Pediatric Patients Undergoing Cardiac Surgery: A Double-Blind, Randomized, Controlled Study
Objective: The objective of this study was to assess the effectiveness of 0.5% ropivacaine used for parasternal intercostal blocks for postoperative analgesia in pediatric patients undergoing cardiac surgery. Design: A randomized, controlled, prospective, double-blind study. Setting: A tertiary care teaching hospital...Does anesthetic technique influence cancer?
Journal of Clinical Anesthesia
Dec 2011
Does anesthetic technique influence cancer?
The spread of cancer involves a plethora of factors, all of which may be influenced by anesthesia. In most cases, significant exposure to anesthesia is of brief duration. However, the timing of anesth…..New technique using an Airtraq optical laryngoscope in emergencies
Journal of Clinical Anesthesia
Dec 2011
New technique using an Airtraq optical laryngoscope in emergencies
The Airtraq optical laryngoscope (Prodol, Ltd, Vizcaya, Spain) is a useful tool during difficult intubation, as it provides the operator with an improved view of the glottis...Pain treatment after craniotomy: where is the (procedure-specific) evidence? A qualitative systematic review
European Journal of Anaesthesiology
Dec 2011
Pain treatment after craniotomy: where is the (procedure-specific) evidence? A qualitative systematic review
Context and objective: Pain following craniotomy has been demonstrated to be frequent and moderate-to-severe in nature. In recent years, the focus on the challenges in treatment of postoperative pain following craniotomy has increased. Fear of using opioids because of their wide array of side-effects has led to the..Epidural anesthesia as a novel anesthetic technique for anterior lumbar interbody fusion
Journal of Clinical Anesthesia
Oct 2011
Epidural anesthesia as a novel anesthetic technique for anterior lumbar interbody fusion
Study Objective: To determine if epidural anesthesia is a reasonable technique for anterior lumbar interbody fusion. Design: Retrospective chart review. Setting: Academic university hospital. Measurements: The charts of patients who underwent an anterior lumbar interbody fusion between January 1, 2001 and November 1,..99mTc-DPD-SPECT/CT predicts the outcome of imaging-guided diagnostic anaesthetic injections: A prospective cohort study
European Journal of Radiology
Oct 2011
99mTc-DPD-SPECT/CT predicts the outcome of imaging-guided diagnostic anaesthetic injections: A prospective cohort study
Purpose: We hypothesized that bone SPECT combined with multiplanar reconstructed CT can identify and target the pain-inducing focus in the foot and can be used to successfully guide anaesthetic infiltrations. Therefore we prospectively investigated feasibility and predictive value of bone SPECT/CT for image guided..Perioperative Assessment of Diastolic Dysfunction
Anesthesia and Analgesia
Aug 2011
Perioperative Assessment of Diastolic Dysfunction
Assessment of diastolic function should be a component of a comprehensive perioperative transesophageal echocardiographic examination. Abnormal diastolic function exists in > 50% of patients presenting for cardiac and high-risk noncardiac surgery, and has been shown to be an independent predictor of adverse..An Intraoperative Small Dose of Ketamine Prevents Remifentanil-Induced Postanesthetic Shivering
Anesthesia and Analgesia
Aug 2011
An Intraoperative Small Dose of Ketamine Prevents Remifentanil-Induced Postanesthetic Shivering
Patients undergoing gynecological laparotomy were randomized to receive either 0.5 mg/kg ketamine at induction of anesthesia followed by an infusion of 0.3 mg/kg/h until the end of surgery (ketamine group, n = 32), or an equivalent volume of normal saline (control group, n = 32). Anesthesia was maintained with IV..An Exploration of Remifentanil-Propofol Combinations That Lead to a Loss of Response to Esophageal Instrumentation, a Loss of Responsiveness, and/or Onset of Intolerable Ventilatory Depression
Anesthesia and Analgesia
Mar 2011
An Exploration of Remifentanil-Propofol Combinations That Lead to a Loss of Response to Esophageal Instrumentation, a Loss of Responsiveness, and/or Onset of Intolerable Ventilatory Depression
Background: Remifentanil and propofol are increasingly used for short-duration procedures in spontaneously breathing patients. In this setting, it is preferable to block the response to moderate stimuli while avoiding loss of responsiveness (LOR) and intolerable ventilatory depression (IVD). In this study, we explored..
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