European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Myocardial oxidative stress protection by sevoflurane vs. propofol: a randomised controlled study in patients undergoing off-pump coronary artery bypass graft surgery.
Myocardial oxidative stress plays an essential role in the pathogenesis of ischaemia-reperfusion injury associated with coronary artery bypass grafting (CABG). Both propofol and volatile anaesthetics have been shown to reduce reactive oxygen species in experimental and clinical studies. ⋯ In patients undergoing off-pump CABG, sevoflurane showed better antioxidative properties than propofol.
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Pain following craniotomy has been demonstrated to be frequent and moderate-to-severe in nature. In recent years, the focus on the challenges in treatment of postoperative pain following craniotomy has increased. Fear of using opioids because of their wide array of side-effects has led to the search for alternative analgesic options. The objective of this systematic review was to evaluate current evidence about analgesic therapy following craniotomy. ⋯ No firm recommendations on analgesic therapy following craniotomy can be given because the number of well performed RCTs is limited and the study populations are very small. However, evidence on scalp infiltration suggests an analgesic effect in the first few postoperative hours. There is an urgent need for well performed RCTs on pain therapy following craniotomy.
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The immediate post-operative period is critical with regard to post-operative outcomes. ⋯ A clinical pathway in a post-anaesthesia care unit can significantly reduce length of stay and can improve post-operative outcome.