Objectives To obtain reliable estimates of the effects of neuraxial blockade with epidural or spinal anaesthesia on postoperative morbidity and mortality. Design Systematic review of all trials with randomisation to intraoperative neuraxial blockade or not.

In this study, the VLS with the Macintosh blade (Storz VLS) had a better overall satisfaction score, intubation time, number of intubation attempts, and necessity of extra adjuncts, compared with the 2 other tested devices.

In this narrative review, we aim to provide the pathophysiology and diagnostic criteria of the piriformis syndrome (PS), an underdiagnosed cause of buttock and leg pain that can be difficult to treat. Based on existing evidence, frequencies of clinical features are estimated in patients reported to have PS. In view of the increasing popularity of ultrasound for intervention, the ultrasound-guided technique in the treatment of PS is described in detail. A literature search of the MEDLINEA (R) database was performed from January 1980 to December 2012 using the search terms e.g., " piriformis injection", " ultrasound guided piriformis injection", " botulinum toxin", "pain management", and different structures relevant in this review. There was no restriction on language. A review of the medical literature pertaining to PS revealed that the existence of this entity remains controversial. There is no definitive proof of its existence despite reported series with large numbers of patients. Piriformis syndrome continues to be a controversial diagnosis for sciatic pain. Electrophysiological testing and nerve blocks play important roles when the diagnosis is uncertain. Injection of local anesthetics, steroids, and botulinum toxin into the piriformis muscle can serve both diagnostic and therapeutic purposes. An ultrasound-guided injection technique offers improved accuracy in locating the piriformis muscle. Optimizing the therapeutic approach requires an interdisciplinary evaluation of treatment

The trachea of a large proportion of patients with normal airways can be intubated successfully with certain VLS blades without using a stylet, although the three studied VLSs clearly differ in outcome. The Storz VLS displaces soft tissues in the fashion of a classic Macintosh scope, affording room for tracheal tube insertion and limiting the need for stylet use compared with the other two scopes. Although VLSs offer several advantages, including better visualization of the glottic entrance and intubation conditions, a good laryngeal view does not guarantee easy or successful tracheal tube insertion. We recommend that the geometry of VLSs, including blade design, should be studied in more detail.

No abstract

Safety and population pharmacokinetic analysis of intravenous acetaminophen in neonates, infants, children, and adolescents with pain or Fever.

All VLSs considered were safer for the patient than was the Macintosh blade in terms of the forces applied to the maxillary teeth, time, number of insertion attempts, and view achieved of the glottic arch. There is a small, but significant, difference in the time and number of insertion attempts required during laryngoscopy with the different VLSs. There was no difference in the forces applied. The geometry of the respective blades may be an important component in the ease of laryngoscopy.

The present study demonstrated the heterogeneity and variety of anaesthesia practices throughout Europe. Standardisation of the training and practice of European nurse anaesthetists is desirable for patient safety and quality of care if they seek to work in more than one European country. Those countries that anticipate a shortfall in the supply of anaesthesiologists should examine working models from other countries that currently work with fewer physicians and more nurse anaesthetists.