European journal of anaesthesiology
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Multicenter Study Observational Study
Mode of blood pressure monitoring and morbidity after noncardiac surgery: A prospective multicentre observational cohort study.
Control of blood pressure remains a key goal of peri-operative care, because hypotension is associated with adverse outcomes after surgery. ⋯ Intra-arterial monitoring is associated with greater risk of morbidity after noncardiac surgery, after controlling for surgical and patient factors. These data provide useful insights into the design of a definitive monitoring trial.
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Randomized Controlled Trial
Effect of dexmedetomidine on Nociception Level Index-guided remifentanil antinociception: A randomised controlled trial.
The effect of dexmedetomidine on Nociception Level Index-guided (Medasense, Israel) antinociception to reduce intra-operative opioid requirements has not been previously investigated. ⋯ In ASA 1 and 2 patients receiving Nociception Level Index-guided antinociception, dexmedetomidine decreases intra-operative remifentanil requirements. Combined frontal electroencephalogram and Nociception Level Index monitoring can measure dexmedetomidine's hypnotic and opioid-sparing effects during remifentanil-propofol target-controlled infusion anaesthesia.
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In the United States, postoperative opioid prescriptions have been implicated in the so-called 'opioid epidemic'. In Europe, the extent of overprescribing or misuse of opioids is not known. ⋯ PROSPERO: CRD42019154292.
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Randomized Controlled Trial
Protective effect of sevoflurane on vascular endothelial glycocalyx in patients undergoing heart valve surgery under cardiopulmonary bypass: A randomised controlled trial.
The glycocalyx plays an important physiological role and may be damaged during cardiopulmonary bypass. Sevoflurane can protect the glycocalyx; however, its relevance in a clinical setting is unknown. ⋯ Sevoflurane can decrease glycocalyx degradation in patients undergoing heart valve surgery under cardiopulmonary bypass.
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Observational Study
Prolonged time to extubation after general anaesthesia is associated with early escalation of care: A retrospective observational study.
Prolonged time to extubation after general anaesthesia has been defined as a time from the end of surgery to airway extubation of at least 15 min. This occurrence can result in ineffective utilisation of operating rooms and delays in patient care. It is unknown if unanticipated delayed extubation is associated with escalation of care. ⋯ Prolonged time to extubation occurred in nearly 10% of cases and was associated with an increased incidence of escalation of care. Many independent factors associated with 'prolonged extubation' were nonmodifiable by anaesthetic management.