Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Jul 2014
Review Meta AnalysisDexmedetomidine for preventing sevoflurane-related emergence agitation in children: a meta-analysis of randomized controlled trials.
Emergence agitation (EA) is a common problem after sevoflurane anesthesia in children. Prophylactic dexmedetomidine has been directed at this issue; however, the efficacy remains controversial. We therefore conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate the effectiveness of dexmedetomidine on the incidence of sevoflurane-related EA. ⋯ Dexmedetomidine reduced the incidence of sevofurane-related EA (pooled RR = 0.351; 95% CI: 0.275-0.449; P = 0.965; heterogeneity test, I(2) = 0.0%), and it also resulted in a lower incidence of severe EA (pooled RR = 0.119; 95% CI: 0.033-0.422; P = 0.962; heterogeneity test, I(2) = 0.0%). All subgroup analyses for potential sources of heterogeneity showed a lower incidence of sevoflurane-related EA after dexmedetomidine administration. This meta-analysis demonstrated that dexemedetomidine was effective in reducing the incidence of sevoflurane-induced EA in children as compared with placebo.
-
Acta Anaesthesiol Scand · Jul 2014
Observational StudyConcentrations of remifentanil, propofol, fentanyl, and midazolam during rewarming from therapeutic hypothermia.
The clearance of sedatives and analgesics may be reduced by therapeutic hypothermia. However, little is known about the concentrations of such drugs during rewarming. The aim of this study was to describe the serum concentrations of sedatives and analgesics during rewarming from therapeutic hypothermia. ⋯ Concentrations of remifentanil, propofol, and midazolam decreased during rewarming from therapeutic hypothermia when adjusting for rates of infusion. No changes were demonstrated for fentanyl.
-
Acta Anaesthesiol Scand · Jul 2014
Comparative StudyKnee surgery recovery: Post-operative Quality of Recovery Scale comparison of age and complexity of surgery.
Initial validation and feasibility for the Post-operative Quality of Recovery Scale (PQRS) was published in 2010. Ongoing validation includes studies to determine whether this scale can discriminate differences in recovery between cohorts. ⋯ Knee replacement had a large effect on recovery compared with knee arthroscopy. Age had minimal effect on recovery after knee arthroscopy. The study showed the ability of the PQRS to discriminate recovery in different domains.
-
Acta Anaesthesiol Scand · Jul 2014
Comparative Study Observational StudySerum high-mobility group box 1 protein correlates with cognitive decline after gastrointestinal surgery.
Accumulating evidence has indicated that inflammation may act as a potential mechanism underlying post-operative cognitive dysfunction (POCD). High-mobility group box 1 (HMGB1), as a known late mediator of inflammation, is involved in the development of post-operative complications. Thus, we sought to determine the role of HMGB1 in reflecting POCD following major gastrointestinal surgery. ⋯ Serum HMGB1 and IL-6 levels increase significantly after major gastrointestinal surgery in elderly patients and such elevations are associated with the occurrence of cognitive decline after surgery.