SummaryTen volunteers, with no previous experience of resuscitation, were .formally trained in the use of the laryngeal mask airway and the oropharyngeal airway (Guedel) I bag and facemask for manual ventilation ofthe lungs in I04Jit, anaesthetised adults. They then used both airways in turn. The order of insertion was randomly allocated. and the times taken ,for insertion were also recorded. Ventilation for each airway was deemed to be successful v a n increase in end-tidal carbon dioxide partial pressure did not occur and arterial oxygen saturation remainedgreater than 90%. Success rates for the laryngeal mask airway and the Guedel airway, bag and.facemask were 87% and 43% respectively ( p < 0.001) and the average insertion times were 27.4 s (SEM 1.5) and 15.8 s (SEM 0.50) (no signijicant difference), respectively. The laryngeal mask airway proved to be easier to use for manual ventilation than the Guedel airway, bag and mask for inexperienced personnel who had received a period of ,formal training in both techniques.

HPSV may cause serious complications and there are wide variations in clinical practice. This is an area where guideline development and examination of outcome data are warranted.

SummarySixty ASA I and II patients, premedicated with midazolam, were administered propofol 2 mg.kg ¹1 and remifentanil 3 mg.kg ¹1 (group R3), remifentanil 4 mg.kg ¹1 (group R4) and remifentanil 5 mg.kg ¹1 (group R5). Laryngoscopy and intubation were performed 1 min after the administration of the study drugs and the intubating conditions were assessed. Good to excellent conditions were observed in 12 patients in group R3 compared with 19 patients each in groups R4 and R5 (p ¼ 0.004). Significant reductions in mean arterial pressure (MAP) and heart rate (HR) after administration of the study drug were observed in each group, p < 0.01. There was, however, no difference in mean MAP and HR between the three groups at all time points. We conclude that remifentanil 4-5 mg.kg ¹1 may reliably provide good to excellent conditions for tracheal intubation when administered after propofol 2 mg.kg ¹1 .

Summary In a randomised, placebo-controlled trial we have compared the eflcacy of ondansetron and droperidol in reducing postoperative

No abstract

We performed a double-blind, placebo-controlled study to evaluate the different methods of administering droperidol in patients using patient-controlled analgesia (PCA) with morphine. Eighty patients undergoing major orthopedic procedures received temazepam 0.2 mg/kg orally followed by induction of general anesthesia with propofol 2.5 mg/kg, fentanyl 2 micrograms/kg, and vecuronium 0.1 mg/kg. Anesthesia was maintained with nitrous oxide, oxygen, and enflurane. At the end of surgery, all patients received PCA with morphine (0.5 mg/mL, bolus dose 1 mg, and lockout interval 5 min. Before commencement of PCA, patients were randomized to receive droperidol 1.25 mg immediately and, in addition, droperidol 0.16 mg with each PCA dose (Group 1), droperidol 1.25 mg immediately (Group 2), droperidol 0.16 mg with each PCA dose (Group 3), and no droperidol (Group 4). Incidence of nausea and vomiting, request for rescue antiemetics, sedation score, and side effects were recorded every 4 h. Droperidol significantly reduced the incidence of postoperative nausea and vomiting (PONV) (P < 0.01) and request for rescue antiemetic (P < 0.01) compared to placebo. However, there was no difference in the incidence of PONV between droperidol given either as a single dose at the end of surgery (Group 2) or mixed in morphine PCA (Group 3). The addition of droperidol in PCA after an initial dose (Group 1) should be avoided, as it resulted in more sedation and no further reduction in the incidence of PONV compared to Groups 2 and 3.

SummarySixty ASA physical status I and II, premedicated patients were administered propofol 2 mg.kg ¹1 and remifentanil 2 mg.kg ¹1 (group R), alfentanil 50 mg.kg ¹1 (group A) or suxamethonium 1 mg.kg ¹1 (group S) as a rapid bolus. One minute after study drug administration, tracheal intubation was performed. Intubation conditions were then scored. Excellent or good conditions were observed in only 35% in group R compared with groups S and A (100% and 85%, respectively; p < 0.001). The haemodynamic response to tracheal intubation was blunted in groups R and A compared with group S (p < 0.001). The mean heart rate in groups R and A was significantly lower than group S (p < 0.001). We conclude that remifentanil 2 mg.kg ¹1 given as a rapid bolus will not produce intubating conditions as good as those obtained with alfentanil 50 mg.kg ¹1 or suxamethonium 1 mg.kg ¹1 if administered after propofol 2 mg.kg ¹1 .

Thromboelastography is a test that could potentially correlate with the degree of anticoagulation produced by low molecular weight heparin. The r time from the thromboelastogram correlates with serum anti-Xa concentration.