European journal of anaesthesiology
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Randomized Controlled Trial
Effect of preoperative intravenous carbohydrate loading on preoperative discomfort in elective surgery patients.
We studied the effect of three different fasting protocols on preoperative discomfort and glucose and insulin levels. ⋯ Intravenous glucose infusion does not decrease the sense of thirst and hunger as effectively as a carbohydrate-rich drink but does alleviate the feelings of weakness and tiredness compared with fasting.
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Conventional analgesics have limited efficacy in the management of neuropathic pain. An adjuvant analgesic is a drug that has a primary nonpain indication but which may be analgesic in certain circumstances, and many of these have established a role in the pharmacological treatment of neuropathic pain. ⋯ Cost-effectiveness data are absent for the vast majority of these drugs. Pharmacological treatments should be used as part of a multimodal therapeutic programme for the management of neuropathic pain.
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Pancuronium, vecuronium, mivacurium and rocuronium are nondepolarizing neuromuscular blocking agents, which are competitive antagonists against acetylcholine at nicotinic receptors, and considered to have no direct actions on vascular smooth muscle. We aimed to investigate the relaxant effects and possible underlying mechanisms of these agents on isolated rat thoracic aorta. ⋯ In conclusion, their relaxation effect may be due to an increase in prostaglandin synthesis. The increased relaxation effect of these agents at electrical field stimulation may be by the decreasing effect of noradrenaline reuptake from nerve endings because a noradrenaline reuptake inhibitor desipramine did not change this effect. Also, these neuromuscular agents may affect beta-receptors, because a nonselective beta-blocker agent, propranolol, decreased their electrical field stimulation-induced relaxations.
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Comparative Study
Teaching anaesthesia induction to medical students: comparison between full-scale simulation and supervised teaching in the operating theatre.
The aim of the study was to compare the effectiveness of teaching of general anaesthesia induction to medical students using either full-scale simulation or traditional supervised teaching with patients in the operating theatre. ⋯ The simulation group performed better in 25% of the tasks and similarly in the others compared with the traditional teaching group. With the same time and amount of teaching personnel we trained five or six students in the simulator compared with one student in the operating theatre. Further research will reveal whether these promising results with simulation may be applied more generally in anaesthesiology teaching to medical students.
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The aim of the present study was to test the efficacy of adaptive support ventilation (ASV) to automatically adapt the ventilatory settings to the changes in the respiratory mechanics that occur during pneumoperitoneum and Trendelenburg position in gynaecological surgeries. ⋯ In healthy women undergoing gynaecologic laparoscopy, ASV automatically adapted the ventilatory settings to the changes in the respiratory mechanics, keeping constant the preset minute ventilation, providing an adequate exchange of respiratory gases and obviating clinician's interventions.