Ventilatory performance of AMBU® AuraGain™ and LMA® Supreme™ in laparoscopic surgery: A randomised controlled trial

2021 ◽  
pp. 0310057X2110305
Author(s):  
Jinbin Zhang ◽  
Paul A Drakeford ◽  
Vicky Ng ◽  
Zhiquan Seng ◽  
Maureen Chua ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Laparoscopic Cholecystectomy ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Primary Outcome Measure ◽  
Carbon Dioxide Insufflation ◽  
Inguinal Herniorrhaphy ◽  
Lma Supreme ◽  
American Society ◽  
Randomised Controlled

The Ambu® AuraGain™ (Ambu A/S, Ballerup, Denmark) is a newer phthalate-free, single-use supraglottic device with the advantage of a facility for tracheal intubation if necessary intraoperatively. We compared the oropharyngeal leak pressures and other performance variables between the AMBU AuraGain and the LMA® Supreme™ (Teleflex Medical, Athlone, Co. Westmeath, Ireland) in patients undergoing laparoscopic cholecystectomy and preperitoneoscopic inguinal herniorrhaphy with carbon dioxide insufflation under controlled ventilation. We recruited 120 American Society of Anesthesiologists physical status class I–3 patients between the ages of 21 and 80 years undergoing laparoscopic cholecystectomy or preperitoneoscopic inguinal herniorrhaphy into this single-centre randomised controlled trial. The primary outcome measure was the oropharyngeal leak pressures. Secondary outcomes included insertion parameters, ventilatory characteristics and postoperative sequelae. The AuraGain had slightly but significantly higher oropharyngeal leak pressures than the LMA Supreme (mean (standard deviation) 26.1 (6.9) versus 21.4 (4.7) cmH2O, P < 0.010). The overall insertion success of the AuraGain was comparable to the LMA Supreme (AuraGain 58/60 (96.7%); LMA Supreme 56/59 (94.9%), P = 0.679). The AuraGain was deemed more difficult to insert than the LMA Supreme, with 26/60 (43.3%) of AuraGain insertions graded easy versus 48/59 (81.4%) of LMA Supreme, P < 0.001. The mean time to insertion of the AuraGain was slightly longer than the LMA Supreme, 32.2 (10.5) versus 28.3 (12.0) s, P < 0.001. Intraoperative device failure occurred following carbon dioxide insufflation in one AuraGain and three LMA Supremes, bringing the perioperative success rate of AuraGain and LMA Supreme to 95% and 89.8%, respectively, P = 0.322. No cases of regurgitation and aspiration occurred, and minor postoperative complications were similar. The AuraGain exhibited higher oropharyngeal leak pressures than the LMA Supreme, but was slightly more difficult to insert. The higher oropharyngeal leak pressures suggest that ventilation might be less affected by high peak inspiratory pressures when using the AuraGain than the LMA Supreme.

scholarly journals Computerised cognitive–behavioural therapy for adults with intellectual disability: randomised controlled trial

2017 ◽  
Vol 211 (2) ◽  
pp. 95-102 ◽  
Author(s):  
Patricia Cooney ◽  
Catherine Jackman ◽  
David Coyle ◽  
Gary O'Reilly
Keyword(s):  
Intellectual Disability ◽  
Randomised Controlled Trial ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Primary Outcome Measure ◽  
Cognitive Behavioural ◽  
Randomised Controlled

BackgroundDespite the evidence base for computer-assisted cognitive–behavioural therapy (CBT) in the general population, it has not yet been adapted for use with adults who have an intellectual disability.AimsTo evaluate the utility of a CBT computer game for adults who have an intellectual disability.MethodA 2 × 3 (group × time) randomised controlled trial design was used. Fifty-two adults with mild to moderate intellectual disability and anxiety or depression were randomly allocated to two groups: computerised CBT (cCBT) or psychiatric treatment as usual (TAU), and assessed at pre-treatment, post-treatment and 3-month follow-up. Forty-nine participants were included in the final analysis.ResultsA significant group x time interaction was observed on the primary outcome measure of anxiety (Glasgow Anxiety Scale for people with an Intellectual Disability), favouring cCBT over TAU, but not on the primary outcome measure of depression (Glasgow Depression Scale for people with a Learning Disability). A medium effect size for anxiety symptoms was observed at post-treatment and a large effect size was observed after follow-up. Reliability of Change Indices indicated that the intervention produced clinically significant change in the cCBT group in comparison with TAU.ConclusionsAs the first application of cCBT for adults with intellectual disability, this intervention appears to be a useful treatment option to reduce anxiety symptoms in this population.

scholarly journals Is 3D faster and safer than 4K laparoscopic cholecystectomy? A randomised-controlled trial

2019 ◽  
Vol 34 (4) ◽  
pp. 1729-1735 ◽  
Author(s):  
Matt Dunstan ◽  
Ralph Smith ◽  
Katie Schwab ◽  
Andrea Scala ◽  
Piers Gatenby ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Randomised Controlled

Carbon dioxide laser treatment in burn-related scarring: A prospective randomised controlled trial

2019 ◽  
Vol 72 (6) ◽  
pp. 863-870 ◽  
Author(s):  
Helen Douglas ◽  
Jessica Lynch ◽  
Karl-Anton Harms ◽  
Tadyn Krop ◽  
Lauren Kunath ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Randomised Controlled Trial ◽  
Laser Treatment ◽  
Carbon Dioxide Laser ◽  
Controlled Trial ◽  
Randomised Controlled

Impact of standard-pressure and low-pressure pneumoperitoneum on shoulder pain following laparoscopic cholecystectomy: a randomised controlled trial

2016 ◽  
Vol 31 (3) ◽  
pp. 1287-1295 ◽  
Author(s):  
Hemanga K. Bhattacharjee ◽  
Azarudeen Jalaludeen ◽  
Virinder Bansal ◽  
Asuri Krishna ◽  
Subodh Kumar ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Randomised Controlled Trial ◽  
Shoulder Pain ◽  
Controlled Trial ◽  
Low Pressure ◽  
Standard Pressure ◽  
Randomised Controlled

scholarly journals A randomised controlled trial of propofol vs. thiopentone and desflurane for fatigue after laparoscopic cholecystectomy

Anaesthesia ◽  
2017 ◽  
Vol 72 (7) ◽  
pp. 864-869 ◽  
Author(s):  
T. Nostdahl ◽  
O. M. Fredheim ◽  
T. Bernklev ◽  
T. S. Doksrod ◽  
R. M. Mohus ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Randomised Controlled

scholarly journals Efficacy of high-volume injections with and without corticosteroid compared with sham for Achilles tendinopathy: a protocol for a randomised controlled trial

2021 ◽  
Vol 7 (4) ◽  
pp. e001136
Author(s):  
Peter Malliaras ◽  
David Connell ◽  
Anders Ploug Boesen ◽  
Rebecca S Kearney ◽  
Hylton B Menz ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
High Volume ◽  
Primary Outcome Measure ◽  
Achilles Tendinopathy ◽  
Double Blind ◽  
Sham Injection ◽  
Intention To Treat ◽  
Randomised Controlled

IntroductionAchilles tendinopathy (AT) is a common and disabling musculoskeletal condition. First-line management involving Achilles tendon loading exercise with, or without, other modalities may not resolve the problem in up to 44% of cases. Many people receive injections. Yet there are no injection treatments with demonstrated long-term efficacy. The aim of the trial is to examine the 12-month efficacy of high-volume injection (HVI) with corticosteroid and HVI without corticosteroid versus sham injection among individuals with AT.Methods and analysisThe trial is a three-arm, parallel group, double-blind, superiority randomised controlled trial that will assess the efficacy of HVI with and without corticosteroid versus sham up to 12 months. We will block-randomise 192 participants to one of the three groups with a 1:1:1 ratio, and both participants and outcome assessors will be blinded to treatment allocation. All participants will receive an identical evidence-based education and exercise intervention. The primary outcome measure will be the Victorian Institute of Sport Assessment – Achilles (VISA-A) at 12 months post-randomisation, a validated, reliable and disease-specific measure of pain and function. Choice of secondary outcomes was informed by core outcome domains for tendinopathy. Data will be analysed using the intention-to-treat principle.Ethics and disseminationEthics approval was obtained via the Monash University Human Ethics Committee (no: 13138). The study is expected to be completed in 2024 and disseminated via peer review publication and conference presentations.Trial registration numberAustralia and New Zealand Clinical trials registry (ACTRN12619001455156)

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