European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative assessment of the effects of alfentanil, esmolol or clonidine when used as adjuvants during induction of general anaesthesia.
This randomized, double-blinded, prospective study compared the effects of clonidine, esmolol or alfentanil on the level of hypnosis and haemodynamic responses to intravenous induction of anaesthesia and endotracheal intubation. ⋯ None of the study drugs blocked the increase in mean arterial pressure induced by endotracheal intubation, but esmolol provided better overall haemodynamic stability. All groups had an adequate level of hypnosis.
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Randomized Controlled Trial Comparative Study Clinical Trial
General anaesthesia combined with bilateral paravertebral blockade (T5-6) vs. general anaesthesia for laparoscopic cholecystectomy: a prospective, randomized clinical trial.
The efficiency of bilateral paravertebral blockade combined with general anaesthesia (active) vs. general anaesthesia alone (control) in reducing postoperative pain following laparoscopic cholecystectomy was evaluated using a prospective randomized study design. ⋯ When used as a complement to general anaesthesia, bilateral nerve-stimulator guided paravertebral blockade with lidocaine, bupivacaine, fentanyl and clonidine may improve postoperative pain relief.
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Randomized Controlled Trial Comparative Study Clinical Trial
Air leakage around endotracheal tube cuffs.
To compare the recently introduced Microcuff endotracheal tube with conventional tubes in respect of the cuff pressures required to prevent air leakage. ⋯ The Microcuff endotracheal tube with its ultra-thin polyurethane cuff membrane required the lowest sealing pressure to prevent air leakage. These features are potentially of interest for long-term intubated patients and for cuffed endotracheal tubes in children, allowing tracheal sealing at lower cuff pressures implying less damage to the trachea.
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In this review paper, the authors critically analyse the use of a number of depth of anaesthesia monitors in light of the most recent literature and their own clinical experience. There appears to be increasing evidence that anaesthesia depth monitors reduce the incidence of unexpected intraoperative awareness and also that they improve the quality of anaesthesia. ⋯ The information provided by anaesthesia depth monitors is detailed and relationships with clinical practice are established to provide the reader with key features for optimal use of those monitors and correct interpretation of data. Practitioners and patient's knowledge and expectations regarding this matter, as well as the cost-benefit relationship are also discussed.
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One of the complications of laparoscopic surgery is carbon monoxide production during electrocautery. The aim of our study was to ascertain the relationship between intraperitoneal and alveolar concentrations of carbon monoxide and systemic carboxyhaemoglobin in patients undergoing laparoscopic cholecystectomy and anaesthetized with a closed system, where the carbon monoxide excreted through the lungs is accumulated in the circuit and thus re-inhaled. ⋯ No significant increase in carboxyhaemoglobin is produced during laparoscopic surgery, even under closed-system anaesthesia without pulmonary carbon monoxide elimination. This is most likely due to a low peritoneal absorption of carbon monoxide. We conclude that in adult patients, no carbon monoxide intoxication is caused if reasonable periods of electrocautery are used and the intraperitoneal gas is regularly renewed.