The Journal of international medical research
-
To determine the relevance of surgery and other causative factors to the incidence of postoperative cognitive dysfunction (POCD) in patients with severe systemic disease. ⋯ Lower baseline MMSE score was the only independent predictor for POCD in patients with severe systemic disease.
-
Clinicians hesitate to perform thoracic paravertebral blockade (TPVB) in children due to the potential high risk of adverse effects. No paediatric anatomical guidelines for TPVB exist. This study aimed to estimate the appropriate depth and distance for safe needle positioning in children. ⋯ These anatomical guidelines for TPVB are recommended to help prevent anaesthetic complications such as pneumothorax, when ultrasonography and CT are unavailable.
-
Practice Guideline Meta Analysis
Development and feasibility study of an algorithm for intraoperative goaldirected haemodynamic management in noncardiac surgery.
This study developed an evidence-based, goal-directed haemodynamic management algorithm to standardize intraoperative haemodynamic therapy. A systematic literature search identified three haemodynamic management goals: stroke volume optimization by fluid therapy; maintenance of a target mean arterial pressure by vasopressor therapy; maintenance of a target cardiac index≥2.5 l/min per m2 by inotropic therapy. ⋯ Implementation of the algorithm into routine intraoperative management in noncardiac surgery was shown to be feasible. Compared with conventional haemodynamic management, use of the algorithm significantly reduced length of hospital stay, requirement for ventilation and incidence of prolonged hospital stay, thereby resulting in reduced hospital costs.
-
Randomized Controlled Trial
Addition of adrenaline to chloroprocaine provides a moderate duration time for epidural anaesthesia in elective caesarean section.
Epidural anaesthesia using chloroprocaine with or without adrenaline and lidocaine with adrenaline were compared. ⋯ Epidural anaesthesia using chloroprocaine with adrenaline has a quick onset and moderate duration and is an attractive alternative to lidocaine and adrenaline or chloroprocaine alone for caesarean section.
-
Randomized Controlled Trial Comparative Study
Optimal bent length of lightwand for intubation in adults: a randomized, prospective, comparative study.
To evaluate the effect on intubation success of different bent lengths of a lightwand (a malleable illuminating stylet used for intubation), based on the patient's thyroid prominence-to-mandibular angle distance (TMD), thyroid prominence-to-incisor distance (TID) and gender. ⋯ Gender-determined bent length was more suitable for lightwand-guided intubation than TID or TMD. For most patients, the optimal bent length was in the range of 6.0-6.9 cm.