Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2019
Randomized Controlled TrialAdductor canal block with a suture-method catheter - A parallel or perpendicular approach?
We performed a randomised blinded pilot study in 16 healthy volunteers to assess whether placing a suture-method catheter in the adductor canal is feasible with two different insertion techniques. ⋯ The suture-method catheter can be placed in the adductor canal with high success rates for initial placement with both techniques.
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Acta Anaesthesiol Scand · Apr 2019
Randomized Controlled TrialRemote ischaemic preconditioning increases serum extracellular vesicle concentrations with altered micro-RNA signature in CABG patients.
Remote ischaemic preconditioning (RIPC) can attenuate myocardial ischaemia/reperfusion injury but its underlying mechanisms remain largely unknown. Recently, extracellular vesicles (EVs) containing microRNAs (miRNAs) were shown to mediate distant intercellular communication that may be involved in cardioprotection. We tested the hypothesis that RIPC in anaesthetized patients undergoing coronary artery bypass (CABG) surgery results in the release of EVs from the ischaemic/reperfused arm into the blood stream harbouring cardioprotective miRNAs. ⋯ Remote ischaemic preconditioning increases serum EV concentrations, most likely by early EV release from the patients' left (RIPC) arm, alters their miRNA signature, and is associated with myocardial protection. Thus, an increased EV concentration with an altered miR-signature may mediate the RIPC effect.
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Acta Anaesthesiol Scand · Apr 2019
Randomized Controlled TrialThe effect of isocapnic hyperventilation on early recovery after remifentanil/sevoflurane anesthesia in O2 /air: A randomized trial.
Isocapnic hyperventilation (ICHV) may hasten emergence from general anesthesia but remains inadequately studied. We prospectively determined emergence time after sevoflurane anesthesia of variable duration with and without ICHV. ⋯ Isocapnic hyperventilation only had a small effect on emergence times after anesthesia, suggesting that isocapnic hyperventilation may have limited clinical benefits with modern potent inhaled anesthetics.
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Acta Anaesthesiol Scand · Apr 2019
Randomized Controlled TrialSupervised exercise training with multimodal pre-habilitation leads to earlier functional recovery following colorectal cancer resection.
Exercise training is a component of the pre-habilitation program. While in one previous study the training was home-based, in a subsequent investigation it was supervised in hospital. The hypothesis of this secondary analysis of the two studies was to determine whether supervised exercise further accelerates the return to baseline walking ability. ⋯ Supervised exercise training leads to meaningful changes in functional capacity thus accelerating the postoperative return to baseline activities.
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Acta Anaesthesiol Scand · Apr 2019
Randomized Controlled TrialEffects of thoracic epidural analgesia on exercise-induced myocardial ischaemia in refractory angina pectoris.
Thoracic epidural analgesia (TEDA) was offered to patients with refractory angina pectoris. Our primary objectives were to evaluate TEDAs´ influence on quality of life (QoL, base for power analysis), and hypothesising that TEDA with bupivacaine during 1 month counteracts exercise-induced myocardial hypoperfusion and increase physical performance. ⋯ In refractory angina, TEDA with bupivacaine inhibits myocardial ischaemia in contrast to TEDA with saline. Regardless of whether bupivacaine or saline is applied intermittently every day, TEDA during 1 month improves the quality of life and reduces angina, even when physical performance remains low. A significant placebo effect has to be considered.