As part of a multimodal analgesic regimen, subarachnoid morphine provided superior analgesia when compared with ultrasound-guided transversus abdominis plane block after cesarean delivery, yet at the cost of increased side effects.

SummaryDuring apnoea following induction of anaesthesia, morbidly obese patients may suffer a rapid decrease in oxygen saturation. This study compares pre-oxygenation alone with pre-oxygenation followed by nasopharyngeal oxygen insufflation on the onset of desaturation occurring during the subsequent apnoea. A randomised controlled trial was performed in 34 morbidly obese patients undergoing gastric bypass or gastric band surgery. Seventeen patients received nasopharyngeal oxygen supplementation following pre-oxygenation (Study group, body mass index = 41.8 (6.9) kg.m ). Time from the onset of apnoea until S p O 2 fell to 95% was compared between the two groups with a cut-off of 4 min. In the control group, the S p O 2 fell from 100% to 95% during the subsequent apnoea in 145 (27) s, with a significantly negative correlation (r 2 = 0.66, p < 0.05) between the time to desaturation to 95% and the body mass index. In the study group, the S p O 2 was maintained in 16 of 17 patients at 100% for 4 min when apnoea was terminated. In conclusion, nasopharyngeal oxygen insufflation following pre-oxygenation in morbidly obese patients delays the onset of oxyhaemoglobin desaturation during the subsequent apnoea.

Low-dose remifentanil during emergence did not prolong wake-up but reduced the incidence and severity of coughing from the endotracheal tube.

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