An FIC block is more efficacious than i.v. alfentanil in terms of facilitating the lateral position for spinal anaesthesia in elderly patients undergoing surgery for femoral neck fractures.

Purpose The 90°rotation technique for inserting the ProSeal TM laryngeal mask airway (PLMA) in anesthetized paralyzed patients was compared with the index finger insertion technique. Methods One hundred twenty Asian adult patients were randomly allocated to either a standard technique group or a rotation technique group. A PLMA size 4 was used for women and size 5 was used for men. In the standard technique group (n = 60), the PLMA was inserted using the index finger. In the rotation technique group (n = 60), the entire cuff of the PLMA was placed in the patient's mouth in a midline approach without finger insertion, rotated 90°c ounter clockwise around the patient's tongue, advanced and then rotated back until resistance was felt. The primary outcome was success at first insertion. Secondary outcome measures were insertion time and complications. Results The success rate at first insertion was greater for the rotation technique group than for the standard technique group (100% vs 83%, respectively; P = 0.003), and less time was required (11 ± 3 sec vs 19 ± 16 sec, respectively; P = 0.03). The incidence of postoperative sore throat was lower for the rotation technique group than for the standard technique group (12% vs 33%, respectively; P = 0.009), and blood staining on the PLMA was less (8% vs 40%, respectively; P \ 0.001).Conclusion The 90°rotation technique for inserting the PLMA is more successful than the standard index finger insertion technique. It is associated with fewer side effects, such as blood on the PLMA and sore throat, which suggests it causes less pharyngeal trauma. (Clinical trial registration number: NCT00966186). RésuméObjectif La technique de rotation a`90°pour inse´rer le masque larynge´ProSeal TM (PLMA) chez des patients anesthe´sie´s curarise´s a éte´compare´e à la technique d'insertion avec l'index. Méthode Cent vingt patients adultes asiatiques ont e´teá le´atoirement re´partis en deux groupes, soit un groupe avec technique d'insertion standard et l'autre avec technique de rotation. Un masque PLMA de taille 4 a e´te´utilise´chez les femmes et un masque de taille 5 chez les hommes. Dans le groupe avec technique d'insertion standard (n = 60), le PLMA a e´te´inse´re´a`l'aide de l'index. Dans le groupe avec technique de rotation (n = 60), la manchette du PLMA a e´te´place´e en entier dans la bouche du patient a`l'aide d'une approche par ligne me´diane sans insertion de doigt, tourne´e de 90°dans le sens inverse des aiguilles d'une montre autour de la langue du patient, avance´e puis retourne´e jusqu'a`ressentir une re´sistance. Le crite`re d'e´valuation principal e´tait la re´ussite a`la premie`re insertion. Les crite`res d'e´valuation secondaires comprenaient le temps d'insertion et les complications. Résultats Le taux de re´ussite a`la premie`re insertion e´tait plus e´leve´dans le groupe avec technique de rotation que dans le groupe avec technique d'insertion standard (100 %

The 90° rotation technique improves ease of insertion of the LMA ProSeal in children, and it decreases the risk of pharyngeal trauma. (ClinicalTrials.gov number, NCT01076725).

No abstract

Both agents can be used safely during strabismus surgery in paediatric patients.

Therapeutic study, Level I.

Both ACS and PCS using propofol provided reduced anxiety compared with control, but patient's satisfaction was higher in the PCS group compared with ACS group.

BackgroundThe purpose of the present study is to investigate the anesthetic effect of reduced doses of spinal bupivacaine with epidural top ups in comparison with those of spinal bupivacaine and to determine the adequate doses of drugs used during lower extremity surgeries.MethodsSixty adult patients were randomized to three different technique groups: S group (10 mg of spinal bupivacaine), SE1 group (7.5 mg of spinal bupivacaine + epidural 1.5% lidocaine 10 ml) or SE2 group (5 mg of spinal bupivacaine + epidural 1.5% lidocaine 10 ml). The level of sensory block, modified Bromage motor scores (MBS), systolic blood pressure and heart rate were recorded for 30 min following anesthesia. Peak sensory block height and MBS, time for sensory regression to L1 and motor recovery to MBS 1, side effects and operator's satisfaction were noted.ResultsThe levels of peak sensory block were similar among the groups (P > 0.05). For the SE2 group, the regression to the L1 dermatome was faster (P = 0.004) and the maximum MBS was lower (P = 0.001) than that of the other two groups. Motor block recovery to MBS 1 was faster for the SE1 and SE2 groups than for the S group (P < 0.001). The operator's satisfaction scores of the SE2 group were lower than those of the other two groups (P = 0.019).ConclusionsDuring combined spinal-epidural anesthesia, 7.5 mg of spinal bupivacaine and epidural 1.5% lidocaine 10 ml produced faster motor recovery than did 10 mg of spinal bupivacaine in patients undergoing lower extremity surgeries.