Anesthesia and analgesia
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Anesthesia and analgesia · Jul 2015
Review Meta AnalysisThe Effect of Adding a Background Infusion to Patient-Controlled Epidural Labor Analgesia on Labor, Maternal, and Neonatal Outcomes: A Systematic Review and Meta-Analysis.
PCEA with a continuous background is associated with longer second stage and greater instrumented delivery than PCEA without a background.
pearl -
Anesthesia and analgesia · Jul 2015
Randomized Controlled Trial Comparative StudyA Comparative Evaluation of Nebulized Dexmedetomidine, Nebulized Ketamine, and Their Combination as Premedication for Outpatient Pediatric Dental Surgery.
Nebulized ketamine with dexmedetomidine is suitable and effective for pediatric premedication before outpatient dental surgery.
pearl -
Anesthesia and analgesia · Jul 2015
Controlled Clinical TrialThe ED90 of Prophylactic Oxytocin Infusion After Delivery of the Placenta During Cesarean Delivery in Laboring Compared with Nonlaboring Women: An Up-Down Sequential Allocation Dose-Response Study.
Labouring women already exposed to oxytocin require a higher dose of oxytocin after cesarean section than non-labouring women to achieve the same uterotonic effect.
pearl -
The Fontan operation places the systemic and pulmonary circulations in series, driven by a single ventricular chamber. It has become the treatment strategy of choice for palliating single-ventricle congenital heart disease. This anatomy engenders profound changes in physiology, affecting the cardiovascular and respiratory systems with direct implications for anesthetic and intensive care. The physical basis of these changes and their sequelae are reviewed.
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Anesthesia and analgesia · Jul 2015
Comparative StudyAn Exploratory Cohort Study Comparing Prothrombin Complex Concentrate and Fresh Frozen Plasma for the Treatment of Coagulopathy After Complex Cardiac Surgery.
Administration of coagulation factor concentrates to treat bleeding after cardiac surgery with cardiopulmonary bypass might be a strategy for reducing allogeneic blood transfusions, particularly for patients treated with warfarin preoperatively. We performed an exploratory analysis on whether the use of prothrombin complex concentrate (PCC) is safe and effective compared with fresh frozen plasma (FFP) to treat coagulopathy after pulmonary endarterectomy surgery with deep hypothermic circulatory arrest. ⋯ This retrospective analysis suggests that PCC may be an alternative to FFP in patients previously treated with warfarin who are coagulopathic after major cardiac surgery. Randomized controlled studies powered to evaluate efficacy and important postoperative outcomes for patients receiving PCC versus FFP for coagulopathic bleeding after cardiopulmonary bypass are warranted.