Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 2014
Randomized Controlled Trial Comparative StudyDexamethasone for pain after outpatient shoulder surgery: a randomised, double-blind, placebo-controlled trial.
Preoperative IV dexamethasone reduces pain after arthroscopic shoulder surgery.
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Acta Anaesthesiol Scand · Jul 2014
ReviewNew oral anticoagulants: clinical indications, monitoring and treatment of acute bleeding complications.
New oral anticoagulants like the direct thrombin inhibitor, dabigatran (Pradaxa®), and factor Xa-inhibitors, rivaroxaban (Xarelto®) and apixaban (Eliquis®) are available for prophylaxis and treatment of thromboembolic disease. They are emerging alternatives to warfarin and provide equal or better clinical outcome together with reduced need for routine monitoring. Methods for measuring drug concentrations are available, although a correlation between plasma drug concentrations and the risk of bleeding has not been firmly established. ⋯ Further challenges regarding patients receiving new oral anticoagulants who presents with major bleeding or need for emergency surgery pose a unique problem. No established agents are clinically available to reverse the anticoagulant effect, although preclinical data report prothrombin complex concentrate as more efficient than fresh frozen plasma or other prohaemostatic agents. This review summaries current knowledge on approved new oral anticoagulants and discusses clinical aspects of monitoring, with particular focus on the management of the bleeding patient.
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Acta Anaesthesiol Scand · Jul 2014
Randomized Controlled Trial Comparative StudyEffect of n-3 fatty acids on markers of brain injury and incidence of sepsis-associated delirium in septic patients.
Data regarding immunomodulatory effects of parenteral n-3 fatty acids in sepsis are conflicting. In this study, the effect of administration of parenteral n-3 fatty acids on markers of brain injury, incidence of sepsis-associated delirium, and inflammatory mediators in septic patients was investigated. ⋯ Administration of n-3 fatty acids did not affect markers of brain injury, incidence of sepsis-associated delirium, and inflammatory mediators in septic patients.
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Acta Anaesthesiol Scand · Jul 2014
Randomized Controlled Trial Comparative StudyPost-operative atelectasis - a randomised trial investigating a ventilatory strategy and low oxygen fraction during recovery.
Atelectasis is common during and after general anaesthesia. We hypothesized that a ventilation strategy with a combination of 1) continuous positive airway pressure (CPAP) or positive end-expiratory pressure (PEEP) and 2) a reduced end-expiratory oxygen concentration during recovery would reduce post-operative atelectasis. ⋯ Inducing anaesthesia with CPAP/PEEP and FIO2 1.0 and deliberately reducing FIO2 during recovery before removal of the LMA did not reduce post-operative atelectasis compared with FIO2 1.0 before removal of the LMA.