European journal of anaesthesiology
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Randomized Controlled Trial
Dexmedetomidine and meperidine prevent postanaesthetic shivering.
This placebo-controlled study was performed to evaluate the efficacy of dexmedetomidine compared with meperidine and placebo in preventing postanaesthetic shivering. ⋯ Intraoperative intravenously administration of dexmedetomidine 1 microg kg(-1) reduces postanaesthetic shivering as does meperidine 0.5 mg kg(-1) in patients after major surgery.
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Quality of acute pain management is far from being satisfactory. These deficits are not caused by the complexity of the medical problem but by difficulties in organization and hospital structures, sand procedures. Continuous quality improvement is a recommended tool to overcome such difficulties and to increase quality in the long run. This study reports the implementation of benchmarking-based continuous quality improvement to improve postoperative pain management at a university hospital. ⋯ A continuous quality improvement process could be established and is now successfully used in clinical routine. Cornerstones of this project were frequent assessments of process and outcome parameters, regular benchmarking and implementation of feedback mechanisms. Changes in organization of medical management and multidisciplinary teamwork seem to be more important than medical or technical aspects.
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Recently published guidelines for checking anaesthetic equipment do not contain specific advice on how to check the correct functioning of the capnograph before inducing anaesthesia. ⋯ The most common method for testing capnograph function among consultant anaesthetists and their assistants in the UK is the direct measurement of exhaled breath.
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We conducted this study in order to evaluate the potential myotoxic effects of ropivacaine after single injection in rats and the time-course of the possible damage. ⋯ Ropivacaine after single intramuscular injection caused reversible muscle damage in a dose-dependent manner.
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Inhalation anaesthetics given only during post-ischaemic reperfusion have some protective effect against reperfusion injury in the heart. Adenosine triphosphate-regulated mitochondrial potassium channels have been shown to be an important mediator of cardioprotection. Thus, we investigated whether 5-hydroxydecanoate, a putative mitochondrial potassium channel blocker, prevents the cardioprotective effect of volatile anaesthetics. ⋯ 5-hydroxydecanoate alone caused no significant changes in haemodynamics and myocardial metabolism. However, the combination of 5-hydroxydecanoate and volatile anaesthetics impaired the recovery from ischaemia. Although animal data cannot be extrapolated to human beings, we suggest that more attention be paid to patients on sulphonylurea drugs, which inhibit potassium channels, when they are anaesthetized with volatile anaesthetics.