Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2014
Components of pain assessment after laparoscopic donor nephrectomy.
Pain after laparoscopic surgery can be divided into three components: incisional or superficial wound pain, deep intra-abdominal pain and referred shoulder pain. Better understanding and adequate assessment of post-operative pain may be an important clue to the optimisation of recovery after laparoscopic surgery. Therefore, we performed a components of pain assessment after laparoscopic donor nephrectomy. ⋯ The components of pain assessment revealed that pain related to the Pfannenstiel incision and the deep intra-abdominal pain component are the most important determinants of pain after laparoscopic donor nephrectomy. Further improvement of the management of post-operative pain should focus on these components of pain.
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Acta Anaesthesiol Scand · Feb 2014
Endogenous amylin and glucagon-like peptide-1 concentrations are not associated with gastric emptying in critical illness.
In health, the hormones amylin and glucagon-like peptide-1 (GLP-1) slow gastric emptying (GE) and modulate glycaemia. The aims of this study were to determine amylin and GLP-1 concentrations in the critically ill and their relationship with GE, glucose absorption and glycaemia. ⋯ In the critically ill, fasting GLP-1, but not amylin, concentrations are elevated and associated with feed intolerance. Neither amylin nor GLP-1 appears to substantially influence the rate of GE.
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Acta Anaesthesiol Scand · Feb 2014
Time-varying spectral analysis revealing differential effects of sevoflurane anaesthesia: non-rhythmic-to-rhythmic ratio.
Heart rate variability (HRV) may reflect various physiological dynamics. In particular, variation of R-R peak interval (RRI) of electrocardiography appears regularly oscillatory in deeper levels of anaesthesia and less regular in lighter levels of anaesthesia. We proposed a new index, non-rhythmic-to-rhythmic ratio (NRR), to quantify this feature and investigated its potential to estimate depth of anaesthesia. ⋯ Our findings suggest that NRR provides complementary information to BIS regarding the differential effects of anaesthetics on the brain, especially the subcortical motor activity.
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Acta Anaesthesiol Scand · Feb 2014
Brain death increases COX-1 and COX-2 expression in the renal medulla in a pig model.
Brain death is linked to a systemic inflammatory response that includes prostaglandins and cytokines among its mediators. The levels of cyclooxygenase-1 and cyclooxygenase-2 (COX-1 and COX-2) affect graft survival, but it remains unknown whether these enzymes are modified during brain death. The aims of this study were to investigate the organ expression of COX and to analyse the cytokine response in the plasma, cerebrospinal fluid (CSF), and organs in a porcine model of intracerebral haemorrhage and brain death. ⋯ Brain death increases the expression of COX-1 and COX-2 mRNA in the renal medulla. The release of cytokines into the plasma and CSF did not vary between the groups.