Anaesthesiology intensive therapy
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Anaesthesiol Intensive Ther · Jan 2019
Comparative StudySupraclavicular block vs. intravenous regional anaesthesia for forearm surgery.
The purpose of this study was to compare the analgesic effect between intravenous regional anesthesia (IVRA) and supraclavicular block in forearm surgery. ⋯ IVRA had shorter onset time and needed less additional anesthetics during surgery, but induced more tourniquet pain and shorter duration of postoperative analgesia than supraclavicular block when 1% lidocaine 20 mL was used for forearm surgery.
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Anaesthesiol Intensive Ther · Jan 2019
Observational StudySeptic shock patients admitted to the intensive care unit with higher SOFA score tend to have higher incidence of abdominal compartment syndrome - a preliminary analysis.
Intra-abdominal hypertension (IAH) is relatively frequent in critical patients. According to the most recent consensus of the World Society of Abdominal Compartment Society (WSACS), there are no predictive factors for IAH diagnosis. Risk factors are the only motivators to date for early IAH diagnosis. Abdominal compartment syndrome (ACS) is defined as sustained intra-abdominal pressure (IAP) maintained above 20 mm Hg (> 3 kPa), with or without abdominal perfusion pressure below 60 mm Hg (< 8 kPa), associated with a new organ dysfunction. Sepsis is a recognized cause of secondary ACS, but to date there is no correlation with admission SOFA (sequential organ failure assessment) score and ACS onset incidence. The objective of the present study is to determine the profile of extra-abdominal septic shock patients with IAH/ACS admitted to the intensive care unit (ICU) and correlating with admission SOFA score. Better understanding of this population may bring to light clinical predictive factors for IAH/ACS early diagnosis. ⋯ The incidence of ACS in patients with extra-abdominal septic shock admitted to a university teaching hospital MICU was higher than those found in the literature. Higher admission and consecutive SOFA score of more than 7 was associated with higher ACS incidence and higher mortality rate.
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Anaesthesiol Intensive Ther · Jan 2019
Level of stress and strategies used to cope with stress by physicians working in intensive care units.
The physicians of intensive care units (ICUs) encounter patients who are critically ill and have severe injuries and require life-saving interventions. Working in such a stressful environment may be highly stressful. A high level of stress among intensive care units' staff is commonly reported. The aim of this study was to explore doctors' perceptions of their stress and identify the coping processes associated with this task. ⋯ Approximately a half of surveyed physicians presented symptoms of a high level of stress, which indicates that it is a very important problem. Further investigations of stress and coping strategies among ICU physicians are necessary.
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Anaesthesiol Intensive Ther · Jan 2018
Randomized Controlled Trial Comparative StudyComparison of propofol-based versus volatile-based anaesthesia and postoperative sedation in cardiac surgical patients: a prospective, randomized, study.
Clinical trials have shown conflicting results regarding the use of volatile anaesthesia before or after an ischaemic insult in cardiac surgical patients and its effect on myocardial injury. This may be attributable to the failure of continuing volatile agents into the early postoperative period. We hypothesised that combined volatilebased anaesthesia and postoperative sedation would decrease the extent of myocardial injury after coronary artery bypass grafting (CABG) when compared with an intravenous, propofol-based approach. This study aimed to assess the feasibility of the perioperative protocol and investigate whether volatile anaesthesia provides cardioprotection in patients undergoing CABG. ⋯ The use of volatile-based anaesthesia and postoperative sedation did not confer any cardioprotection compared with propofol-based anaesthesia and sedation in patients who had good left ventricular function and were undergoing CABG.
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Anaesthesiol Intensive Ther · Jan 2018
C-reactive protein level in plasma and drainage blood depends on the method of anaesthesia and post-operative analgesia after hip surgery.
Serum C-reactive protein (CRP) detects the inflammatory response to surgical trauma in hip surgery. It corresponds to the type of surgery, with a higher level of CRP being found in surgery techniques with greater tissue damage. The aim of our study was to analyze the CRP level in serum and drainage blood after hip surgery in patients with coxarthrosis depending on the method of anaesthesia and post-operative analgesia. ⋯ C-reactive protein levels in plasma and drainage blood depends on the method of anaesthesia and postoperative analgesia after hip surgery. Regional anaesthesia/analgesia methods limit one's inflammatory response to surgical trauma detected by CRP.