Anesthesia and analgesia
-
Anesthesia and analgesia · Sep 2014
Randomized Controlled Trial Multicenter StudyPerioperative Goal-Directed Hemodynamic Optimization Using Noninvasive Cardiac Output Monitoring in Major Abdominal Surgery: A Prospective, Randomized, Multicenter, Pragmatic Trial: POEMAS Study (PeriOperative goal-directed thErapy in Major Abdominal Surgery).
Goal directed fluid and vasoactive therapy using a non-invasive cardiac output monitor does not reduce complications after major abdominal surgery.
pearl -
Anesthesia and analgesia · Sep 2014
Molecular Size and Origin Do Not Influence the Harmful Side Effects of Hydroxyethylstarch on Human Proximal Tubule Cells (HK-2) In Vitro.
Recently, clinical trials revealed renal impairment induced by hydroxyethyl starch (HES) in septic patients. In prior studies, we managed to demonstrate that HES accumulated in renal proximal tubule cells (PTCs). The related pathomechanism has not yet been discovered. To validate our hypothesis that the HES molecule itself is harmful, regardless of its molecule size or origin, we conducted a comprehensive study to elucidate the influences of different HES preparations on PTC viability in vitro. ⋯ For the first time, we were able to show that only the total mass of HES molecules applied is responsible for the harmful impact on renal PTC in vitro. Neither molecular size nor their origin showed any relevance.
-
Anesthesia and analgesia · Sep 2014
ReviewNeurodevelopmental assessment after anesthesia in childhood: review of the literature and recommendations.
Preclinical studies have established that anesthesia is toxic to the brain in neonatal animals, but scant research investigates the neurodevelopmental effects of exposure to anesthesia. In this article, we discuss the issue of outcome measurement of children after anesthesia administered between infancy and approximately 4 years of age. ⋯ The strengths and limitations of this literature is reviewed, followed by a discussion of how future trials investigating neurodevelopmental outcome after anesthesia might be improved by procedures designed specifically to assess the status of the central nervous system. Neuropsychological assessment is described and proposed as a way to increase the validity and sensitivity of forthcoming studies that intend to evaluate the short- and long-term effects of exposure to anesthesia during infancy and early childhood.
-
Anesthesia and analgesia · Sep 2014
Positive end-expiratory pressure to increase internal jugular vein size is poorly tolerated in obese anesthetized adults.
Central venous cannulation is technically challenging in obese patients. We hypothesized that positive end-expiratory pressure (PEEP) increases the size of the internal jugular vein (IJV) in obese adults. ⋯ PEEP modestly increases the size of the IJV in obese adults but was poorly tolerated because of hypotension.
-
Anesthesia and analgesia · Sep 2014
Observational StudyA Prospective Observational Study Evaluating the Ability of Prelabor Psychological Tests to Predict Labor Pain, Epidural Analgesic Consumption, and Maternal Satisfaction.
Psychological characteristics may affect interpretation and expression of pain. In this study, we sought to determine whether validated psychological tests predict the labor pain experience. ⋯ Personality traits (psychoticism, extroversion, and lying), as well as scaled ratings of anxiety, confidence, and analgesia expectations, show some potential to predict labor pain, epidural local anesthetic use, and time to epidural analgesia request. Although ASI was included in the final model for labor pain AUC, and FPQ and PCS were not, further study is required to determine whether ASI is a better predictor than FPQ or PCS.