Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2012
Randomized Controlled Trial Comparative StudySevoflurane vs. propofol in patients with coronary disease undergoing mitral surgery: a randomised study.
Myocardial ischemic damage is reduced by volatile anaesthetics in patients undergoing low-risk coronary artery bypass graft surgery; few and discordant results exist in other settings. We therefore performed a randomised controlled trial (sevoflurane vs. propofol) to compare cardiac troponin release in patients with coronary disease undergoing mitral surgery. ⋯ In this study, patients with coronary artery disease undergoing mitral surgery did not benefit from the cardioprotective properties of halogenated anaesthetics. Sevoflurane anaesthesia was not associated to lower cardiac troponin release when compared with propofol anaesthesia.
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Acta Anaesthesiol Scand · Apr 2012
Randomized Controlled TrialIntravenous lidocaine has no impact on rocuronium-induced neuromuscular block. Randomised study.
Intravenous lidocaine is increasingly used in surgical patients. As it has neuromuscular blocking effects, we tested the impact of an intravenous lidocaine infusion on the time course of a rocuronium-induced neuromuscular block. ⋯ A continuous intravenous infusion of lidocaine has no impact on the time course of the neuromuscular blockade induced by a standard intubation dose of rocuronium.
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Acta Anaesthesiol Scand · Apr 2012
Randomized Controlled TrialDexamethasone does not reduce pain or analgesic consumption after thyroid surgery; a prospective, randomized trial.
Post-operative analgesic effect of a perioperative fixed dose glucocorticoid has been demonstrated in studies on different surgical procedures. The aim of this study was to look for analgesic and opioid sparing effect after thyroid surgery with a weight-adjusted medium dose of dexamethasone compared with placebo or a higher dose. Further, to register other effects and side effects of dexamethasone in the 0–30 days postoperative period. ⋯ Dexamethasone had no analgesic or opioid sparing effect in our set-up after thyroid surgery. Dexamethasone reduced the incidence of PONV and led to a modest increase in blood sugar. A medium dose seems as effective as a higher dose.
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Acta Anaesthesiol Scand · Apr 2012
Randomized Controlled TrialElevated BIS and Entropy values after sugammadex or neostigmine: an electroencephalographic or electromyographic phenomenon?
Sugammadex is designed to antagonize neuromuscular blockade (NMB) induced by rocuronium or vecuronium. In clinical practice, we have noticed a rise in the numerical values of bispectral index (BIS) and Entropy, two electroencephalogram (EEG) - based depth of anesthesia monitors, during the reversal of the NMB with sugammadex. The aim of this prospective, randomized, double-blind study was to test this impression and to compare the effects of sugammadex and neostigmine on the BIS and Entropy values during the reversal of the NMB. ⋯ The EMG contamination of EEG causes BIS and Entropy values to rise during reversal of rocuronium-induced NMB in light propofol-remifentanil anesthesia.
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Acta Anaesthesiol Scand · Apr 2012
ReviewIntranasal fentanyl in the treatment of acute pain--a systematic review.
Due to its non-invasive mode of administration, intranasal (IN) application of drugs may be a valuable alternative to non-invasive pain management. With characteristics that appear to be ideal for IN application, IN fentanyl may have a place in the out-of-hospital treatment and the paediatric population. The objective of this systematic review was to evaluate the current evidence of IN fentanyl in the treatment of acute pain. ⋯ In the paediatric population, results demonstrated some analgesic effect of IN fentanyl following myringotomy, no analgesic effect following voiding cystourethrography, and finally, no significant analgesic difference after long bone fractures, in burns patients, and in post-operative pain relief when compared to IV morphine, oral morphine, or IV fentanyl, respectively. Significant analgesic effect of IN fentanyl was demonstrated in the treatment of breakthrough pain in cancer patients. However, the significant deficiencies in trials investigating acute and post-operative pain, and the paediatric population makes firm recommendations impossible.