European journal of anaesthesiology
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Randomized Controlled Trial
Effect of dexmedetomidine on bleeding during tympanoplasty or septorhinoplasty.
The aim of this study was to evaluate the efficacy of dexmedetomidine, an alpha(2)-adrenoceptor agonist, on intraoperative bleeding, anaesthetic drug requirement and postoperative pain. ⋯ Dexmedetomidine decreased bleeding, postoperative analgesic requirements and intraoperative anaesthetic requirements and was associated with more stable haemodynamic responses to anaesthesia. We conclude that dexmedetomidine is a useful adjuvant to decrease bleeding when a bloodless surgical field is requested.
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Randomized Controlled Trial
Does adding intravenous fentanyl to caudal block in children enhance the efficacy of multimodal analgesia as reflected in the plasma level of catecholamines?
Several studies showed that single analgesic modality management can attenuate perioperative stress, but little is known about the effect of multimodal analgesia on catecholamine responses to surgical trauma in children. ⋯ These findings suggest that the multimodal analgesic approach of adding i.v. low-dose fentanyl to a caudal block may decrease the plasma epinephrine release in children undergoing inguinal herniotomy.
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Dynamic balance involving movement of the centre of gravity is important for the evaluation of street fitness after sedation. The purpose of this study was to compare the recovery of dynamic balance after intravenous sedation with propofol or midazolam, and to investigate the usefulness of simple dynamic balance tests in evaluating the recovery. ⋯ The timed 'up & go' and maximum-speed walking tests are useful simple dynamic balance tests well correlated with precise computerized dynamic posturography for the evaluation of the recovery of dynamic balance from midazolam sedation in younger adults.
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The objective of this study was to determine the intracranial, cardiovascular and respiratory changes induced by conversion to high-frequency oscillator ventilation from conventional mechanical ventilation at increasing airway pressures. ⋯ The use of high positive end expiratory pressure with conventional mechanical ventilation or high continuous distending pressure with high-frequency oscillator ventilation increased intracranial pressure and adversely affected cerebral metabolic indices in this ovine model. Transcranial Doppler is a useful adjunct to intracranial pressure and intracranial venous saturation monitoring when major changes in ventilation strategy are adopted.