European journal of anaesthesiology
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Comparative Study Clinical Trial
The effects of surgical levels of sevoflurane and propofol anaesthesia on heart rate variability.
We compared heart rate dynamics during surgical levels of propofol and sevoflurane anaesthesia in a highly standardized setting. ⋯ Hypnotic levels of sevoflurane and propofol anaesthesia suppressed the heart rate variability measured using conventional analysis methods. Deeper surgical levels of anaesthesia also reduce the complexity of heart rate variability.
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Practice Guideline
Guidelines for sedation and/or analgesia by non-anaesthesiology doctors.
The still ever increasing demand for sedation and/or analgesia for diagnostic and therapeutic procedures puts high pressure on anaesthesia care providers all over Europe. Since the capacity to provide that service by anaesthetists is limited in most European countries, guidelines for non-anaesthetist doctors who want to sedate patients on a high-quality level and especially in a safe way are mandatory. This paper, produced by a working party of the European Board of Anaesthesiology of the European Union of Medical Specialists (EUMS/UEMS), gives direction to those practitioners who feel responsibilities in this area of medicine. Close cooperation with anaesthesiologists seems mandatory to achieve and sustain a high-quality standard for our patients undergoing medical or surgical procedures under sedation.
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Comparative Study
Flow rate, syringe size and architecture are critical to start-up performance of syringe pumps.
Significant start-up delays are inherent to syringe infusion pumps, particularly at low infusion rates, as routinely used in children's anaesthesia and intensive care. Such delays are mainly the result of engagement of gears in the mechanical drive or compliance of the syringe assembly. The purpose of the present study was to determine the effect of flow rate, syringe size and syringe architecture on fluid delivery during infusion start-up. ⋯ Highest possible flow rate, smaller sized syringes and syringe plungers with reduced compressibility should be preferred in order to avoid significant start-up delays in fluid delivery.
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Randomized Controlled Trial
Comparison of laryngeal tube with laryngeal mask airway in anaesthetized and paralysed patients.
The laryngeal mask has become a widely accepted alternative to endotracheal intubation and mask ventilation. The laryngeal tube is a relatively new supraglottic airway device for airway management. We compared the new version of the laryngeal tube with the laryngeal mask. ⋯ With respect to clinical function, the new version of the laryngeal tube and the laryngeal mask are similar and either device can be used to establish a safe and effective airway in paralysed patients.
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The postoperative monitoring and treatment of the patient undergoing aortic valve replacement is a complex challenge. Echocardiography is the only method which provides dynamic and real-time bedside imaging of the heart. Focused assessed transthoracic echocardiography has been shown to provide a usable window for cardiac imaging in a mixed ICU population. The aim of this study was to evaluate the feasibility of perioperative imaging of the heart and pleura according to the focused assessed transthoracic echocardiography protocol in patients scheduled for aortic valve replacement. ⋯ We conclude that the image quality of the heart and pleura, according to the focused assessed transthoracic echocardiography concept, is sufficient to undergo interpretation and thereby contribute to the perioperative clinical decision-making in patients with aortic stenosis.