European journal of anaesthesiology
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Changes in neutrophil and endothelial adhesion molecule expression occur during perioperative ischaemia and reperfusion (I/R) injury. We investigated the effects of lidocaine on neutrophil-independent changes in neutrophil and endothelial adhesion molecule expression associated with tourniquet-induced I/R. ⋯ Increased in vitro neutrophil and endothelial cell adhesion molecule expression on exposure to plasma obtained during the early reperfusion phase is diminished by lidocaine at greater than clinically relevant plasma concentrations.
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The development of acute renal failure (ARF) in critically ill patients is associated with an increase in hospital mortality. Recently, it was shown that starting renal replacement therapy early and using high-filtrate flow rates can improve the outcome, but this could not be confirmed in later investigations. Studying selected patient subgroups could provide a useful basis for patient selection in future trials evaluating the outcome of renal replacement therapies. We, therefore, investigated the impact of the underlying disease on the outcome of patients with ARF. ⋯ Patient selection and subgroup definition according to the underlying disease could augment the usefulness of future trials evaluating the outcome of ARF.
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Difficult intubation in obstetric units has been identified as a major contributory factor to anaesthesia related maternal morbidity and mortality. Availability of equipment for management of a difficult airway is associated with reduced maternal complications. The purpose of our survey was to describe the availability of difficult airway equipment in Irish Obstetric Units. ⋯ Irish Obstetric Units are well equipped according to the international guidelines for difficult intubation equipment. However, we believe that this situation could be further improved by training inexperienced anaesthetists in the use of the Intubating Laryngeal Mask and by the increased use of portable trolleys.
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Continuous spinal analgesia (CSA) offers considerable pain relief, and has been used in various procedures such as for surgery and cancer pain control. In Japan, portable and disposable infusion kits are increasingly employed for continuous epidural analgesia and CSA. In CSA, the use of a microcatheter is expected to reduce the incidence of spinal headache previously encountered with larger catheters. However, the flow rate of disposable infusion kits is reduced when used in conjunction with a microcatheter. ⋯ These results indicated that the use of a shorter microcatheter achieves a better flow rate during CSA.