A comparison of soda lime (Intersurgical) with Amsorb® plus: the cost implications

This was a prospective study comparing the cost implications between two carbon dioxide (CO2) absorbers, soda lime (Intersurgical) and AMSORB® PLUS. The study was conducted over two 4-week periods in two dedicated operating theatres using Datex Ohmeda Aestiva/5 anaesthetic machines. AMSORB® PLUS was used during the first four weeks and soda lime (Intersurgical) the following four weeks. General anaesthesia was administered as routinely done but fresh gas flow (FGF) during the maintenance phase was limited to a maximum flow of 2 L/min. The CO2 absorber was only changed when there was evidence of exhaustion. Total duration of anaesthesia, sevoflurane (bottles) and CO2 absorber (kg) consumption, and amount of waste product (kg) was calculated at the end of each study period. The total cost of delivering general anaesthesia was lower in the AMSORB® PLUS group, RM82.40 (USD19.89)/hour versus the soda lime group, RM91.50 (USD 22.09)/hour (p=0.17), which translates to a 10% reduction in cost per hour. Reduction in sevoflurane consumption in the AMSORB® PLUS compared to the soda lime group was also not statistically significant (p=0.22). The only significant finding was the reduction in CO2 absorber consumption in the AMSORB® PLUS group as compared to soda lime group (p=0.001). In conclusion, AMSORB® PLUS consumption was significantly reduced compared to that of soda lime. However, the use of AMSORB® PLUS did not significantly reduce sevoflurane consumption nor the total cost of delivering general anaesthesia. Given the superior safety profile, AMSORB® PLUS may be a suitable, cost-effective alternative to soda lime in the daily practice of anaesthesia

Analgesia combinada raquiperidural em trabalho de parto: seus efeitos sobre o desfecho do parto

ResumoJustificativa e objetivosA analgesia combinada raquiperidural (RP) tornou‐se uma opção cada vez mais popular para o trabalho de parto tradicional devido ao seu rápido início de ação e ao resultado confiável. Este foi um estudo prospectivo de amostragem conveniente para determinar os efeitos da RP sobre o desfecho do parto.MétodosForam incluídas 110 parturientes primigestas saudáveis, com gestação única de ≥ 37 semanas e na fase ativa do trabalho de parto. As pacientes foram designadas para os grupos RP (n=55) ou não RP (n=55) com base em seus consentimentos para a analgesia combinada RP. As parturientes do grupo não RP receberam outros métodos de analgesia para o parto. As durações do primeiro e segundo estágio do trabalho de parto, as taxas de parto vaginal instrumental e cesariana de emergência e os escores de Apgar foram comparados.ResultadosA média de duração do primeiro e segundo estágio do trabalho de parto não foi significativamente diferente entre os dois grupos. As taxas de parto instrumental não foram significativamente diferentes entre os grupos, RP (11%) versus não RP (16%). A incidência ligeiramente maior de cesariana no grupo RP (16% versus 15% no não RP) não foi estatisticamente significativa. O desfecho neonatal em termos de índice de Apgar foi inferior a 7.ConclusãoNão houve diferenças significativas em relação à duração do trabalho, às taxas de parto vaginal instrumental e cesariana de emergência e ao desfecho neonatal em parturientes que receberam RP para analgesia de parto em comparação com aquelas que não receberam.AbstractBackground and objectivesCombined spinal–epidural (CSE) has become an increasingly popular alternative to traditional labour epidural due to its rapid onset and reliable analgesia provided. This was a prospective, convenient sampling study to determine the effects of CSE analgesia on labour outcome.MethodsOne hundred and ten healthy primigravida parturients with a singleton pregnancy of ≥37 weeks gestation and in the active phase of labour were studied. They were enrolled to the CSE (n=55) or Non‐CSE (n=55) group based on whether they consented to CSE analgesia. Non‐CSE parturients were offered other methods of labour analgesia. The duration of the first and second stage of labour, rate of instrumental vaginal delivery and emergency cesarean section, and Apgar scores were compared.ResultsThe mean duration of the first and second stage of labour was not significantly different between both groups. Instrumental delivery rates between the groups were not significantly different (CSE group, 11% versus Non‐CSE group, 16%). The slightly higher incidence of cesarean section in the CSE group (16% versus 15% in the Non‐CSE group) was not statistically significant. Neonatal outcome in terms of Apgar score of less than 7 at 1 and 5min was similar in both groups.ConclusionThere were no significant differences in the duration of labour, rate of instrumental vaginal delivery and emergency cesarean section, and neonatal outcome in parturients who received compared to those who did not receive CSE for labour analgesia

Combined spinal-epidural analgesia in labour: its effects on delivery outcome

ABSTRACT BACKGROUND AND OBJECTIVES: Combined spinal-epidural (CSE) has become an increasingly popular alternative to traditional labour epidural due to its rapid onset and reliable analgesia provided. This was a prospective, convenient sampling study to determine the effects of CSE analgesia on labour outcome. METHODS: One hundred and ten healthy primigravida parturients with a singleton pregnancy of ≥37 weeks gestation and in the active phase of labour were studied. They were enrolled to the CSE (n = 55) or Non-CSE (n = 55) group based on whether they consented to CSE analgesia. Non-CSE parturients were offered other methods of labour analgesia. The duration of the first and second stage of labour, rate of instrumental vaginal delivery and emergency cesarean section, and Apgar scores were compared. RESULTS: The mean duration of the first and second stage of labour was not significantly different between both groups. Instrumental delivery rates between the groups were not significantly different (CSE group, 11% versus Non-CSE group, 16%). The slightly higher incidence of cesarean section in the CSE group (16% versus 15% in the Non-CSE group) was not statistically significant. Neonatal outcome in terms of Apgar score of less than 7 at 1 and 5 min was similar in both groups. CONCLUSION: There were no significant differences in the duration of labour, rate of instrumental vaginal delivery and emergency cesarean section, and neonatal outcome in parturients who received compared to those who did not receive CSE for labour analgesia

Comparing insertion characteristics on nasogastric tube placement by using GlideScopeTM visualization vs. MacIntosh laryngoscope assistance in anaesthetized and intubated patients

Abstract Background and objective: This was a prospective, randomized clinical study to compare the success rate of nasogastric tube insertion by using GlideScopeTM visualization versus direct MacIntosh laryngoscope assistance in anesthetized and intubated patients. Methods: Ninety-six ASA I or II patients, aged 18-70 years were recruited and randomized into two groups using either technique. The time taken from insertion of the nasogastric tube from the nostril until the calculated length of tube had been inserted was recorded. The success rate of nasogastric tube insertion was evaluated in terms of successful insertion in the first attempt. Complications associated with the insertion techniques were recorded. Results: The results showed success rates of 74.5% in the GlideScopeTM Group as compared to 58.3% in the MacIntosh Group (p = 0.10). For the failed attempts, the nasogastric tube was successfully inserted in all cases using rescue techniques. The duration taken in the first attempt for both techniques was not statistically significant; Group A was 17.2 ± 9.3 s as compared to Group B, with a duration of 18.9 ± 13.0 s (p = 0.57). A total of 33 patients developed complications during insertion of the nasogastric tube, 39.4% in Group A and 60.6% in Group B (p = 0.15). The most common complications, which occurred, were coiling, followed by bleeding and kinking. Conclusion: This study showed that using the GlideScopeTM to facilitate nasogastric tube insertion was comparable to the use of the MacIntosh laryngoscope in terms of successful rate of insertion and complications

Comparing insertion characteristics on nasogastric tube placement by using GlideScopeTM visualization vs. MacIntosh laryngoscope assistance in anaesthetized and intubated patients

Abstract Background and objective: This was a prospective, randomized clinical study to compare the success rate of nasogastric tube insertion by using GlideScopeTM visualization versus direct MacIntosh laryngoscope assistance in anesthetized and intubated patients. Methods: Ninety-six ASA I or II patients, aged 18-70 years were recruited and randomized into two groups using either technique. The time taken from insertion of the nasogastric tube from the nostril until the calculated length of tube had been inserted was recorded. The success rate of nasogastric tube insertion was evaluated in terms of successful insertion in the first attempt. Complications associated with the insertion techniques were recorded. Results: The results showed success rates of 74.5% in the GlideScopeTM Group as compared to 58.3% in the MacIntosh Group (p = 0.10). For the failed attempts, the nasogastric tube was successfully inserted in all cases using rescue techniques. The duration taken in the first attempt for both techniques was not statistically significant; Group A was 17.2 ± 9.3 s as compared to Group B, with a duration of 18.9 ± 13.0 s (p = 0.57). A total of 33 patients developed complications during insertion of the nasogastric tube, 39.4% in Group A and 60.6% in Group B (p = 0.15). The most common complications, which occurred, were coiling, followed by bleeding and kinking. Conclusion: This study showed that using the GlideScopeTM to facilitate nasogastric tube insertion was comparable to the use of the MacIntosh laryngoscope in terms of successful rate of insertion and complications