European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
The influence of perioperative oxygen concentration on postoperative lung function in moderately obese adults.
Obesity aggravates the negative effects of general anaesthesia and surgery on the respiratory system, resulting in decreased functional residual capacity and expiratory reserve volume, and increased atelectasis and ventilation/perfusion (Va/Q) mismatch. High-inspired oxygen concentrations also promote atelectasis. This study compares the effects of perioperative inspired low-oxygen and high-oxygen concentrations on postoperative lung function and pulse oximetry values in moderately obese patients (BMI 25-35). ⋯ We conclude that postoperative lung function and arterial saturation is better preserved by a low-oxygen strategy, although it is not clear whether this has clinical relevance for the prevention of postoperative pulmonary complications.
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Randomized Controlled Trial Comparative Study
Comparative evaluation of propofol 350 and 200 mg for induction of anaesthesia in morbidly obese patients: a randomized double-blind pilot study.
The aim of this pilot study was to evaluate efficacy and safety of propofol 350 versus 200 mg for induction of anaesthesia in morbidly obese patients undergoing bariatric surgery. ⋯ Although propofol 200 mg proved to be an inadequate induction dose for morbidly obese patients, the 350 mg induction dose deserves further study, provided the maintenance dose is not started within 5 min, thereby preventing temporary cardiovascular instability.
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Randomized Controlled Trial Comparative Study
Study of the systemic and pulmonary oxidative stress status during exposure to propofol and sevoflurane anaesthesia during thoracic surgery.
General anaesthesia during mechanical ventilation can induce variable systemic and pulmonary immune effects that may affect postoperative outcome. The aim of the present study was to evaluate evidence of oxidative stress in the blood and bronchoalveolar lavage (BAL) fluid of patients exposed to propofol or sevoflurane anaesthesia during thoracic surgery. ⋯ Sevoflurane seemed to induce a local and systemic oxidative stress, whereas propofol is more likely to have antioxidant properties. Sevoflurane appears to cause a greater intrapulmonary proinflammatory response than propofol during thoracic surgery.
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Randomized Controlled Trial
An opioid-free anaesthetic using nerve blocks enhances rapid recovery after minor hand surgery in children.
The aim of this prospective randomized study was to evaluate the quality of analgesia, postoperative comfort and subsequent duration of hospitalization after distal hand surgery and peripheral nerve block at the wrist for paediatric outpatients. ⋯ The present study demonstrates for the first time that, after distal hand surgery in children, peripheral nerve block improves pain management, opioid analgesia-induced side effects and provides a shorter postoperative recovery time than systemic analgesia with opioids.