ABSTRACT
Background: In obesity, accurate perioperative blood pressure measurement using upper arm, non-invasive blood pressure (NIBP) is technically challenging. Proximal forearm NIBP may be an acceptable substitute. Mean arterial blood pressures (MAP) estimated by proximal forearm NIBP were compared with direct intra-arterial measurements. It was hypothesised that the measurement techniques would be interchangeable if between-technique MAP differed ⤠20% and MAP ratios were < 1.2 and > 0.8. Method: A total of 30 adults with body mass index ⥠30 kg/m2 in whom perioperative intra-arterial blood pressure measurement was considered mandatory were enrolled. MAP measurements using the two techniques were obtained at three random intervals in each patient. BlandAltman analyses were employed. Results: Forearm mean NIBP MAP overestimated mean intra-arterial MAP by 2.2 (SD 8.1; range from 23.8 to 19.4 mmHg; p = 0.011, 95% CI 3.9 to 0.5). However, BlandAltman analyses revealed a wide dispersion with several MAP differences and MAP ratios exceeding the pre-specified bounds for interchangeability. Conclusion: Forearm NIBP could not be considered interchangeable with direct intra-arterial MAP measurements in obese patients
Subject(s)
Blood Pressure , Blood Pressure Determination , Obesity , PatientsABSTRACT
Background: Cutaneous analgesia for venepuncture pain can be achieved using various topically applied local anaesthetic formulations. Xylocaine® 10% Pump Spray containing lignocaine hydrochloride and 95% ethanol is exclusively recommended for mucosal anaesthesia. However, this formulation is readily able to penetrate skin. This study investigated whether topical pretreatment with Xylocaine® 10% Pump Spray could facilitate analgesia for venepuncture. Methods: A single-centre, prospective, randomised, double-blind placebo-controlled trial was conducted. One hundred patients were enrolled. The control and intervention groups had 0.5 ml saline and 0.5 ml Xylocaine® applied for 20 min to preselected venepuncture sites. Pain associated with an 18-gauge cannula venepuncture was rated on an 11-point Numerical Rating Scale. A two-point or 30% reduction in pain would be deemed clinically significant. Results: Pain scores were lower (p = 0.001) in the Xylocaine® (median 2; 95% CI 23) than the saline (median 4; 95% CI 35) group. Moderate-to-severe pain occurred in fewer Xylocaine® (18%) than saline (42%) treated patients (relative risk 0.43, CI 0.22 to 0.48; NNT = 5). Conclusion: Topical Xylocaine® 10% Pump Spray pre-treatment provided a time-effective method of reducing venepunctureassociated pain
Subject(s)
Anesthesia, Local , Bread , LidocaineABSTRACT
A seroepidemiological survey in the Mara Region of Tanzania investigated a randomly selected population between the ages of 15 and 49 in rual and urban areas; as well as a group including high-risk individuals. Reports on 1272 individuals confirm HIV-1 seropositivity in the rural area at under 3 percent; HLTV-1 is present. Preliminary results in the other two groups suggest a higher seroprevelance
Subject(s)
Acquired Immunodeficiency Syndrome , HIV Infections , HIV SeroprevalenceABSTRACT
A seroepidemiological survey in the Mara Region of Tanzania investigated a randomly selected population between the ages of 15 and 49 in rural and urban areas; as well as a group including high-risk individuals. Reports on 1272 individuals confirm HIV-1 seropositivity in the rural area at under 3 percent; HLTV-1 is present. Preliminary results in the other two groups suggest a higher seroprevelance