Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2022
Randomized Controlled TrialQuantitative pupillometry in comatose out-of-hospital cardiac arrest patients: a post-hoc analysis of the TTH48 trial.
Quantitative pupillometry is an objective method to examine pupil reaction and subsequently grade the response on a neurological pupil index (NPi) scale from 0 to 5. The aim of the present sub-study was to explore the long-term prognostic value of NPi in comatose out-of-hospital cardiac arrest patients undergoing targeted temperature management (TTM). ⋯ Quantitative pupillometry measured by NPi was not different in the two TTM groups, but overall, significantly associated with good and poor neurological outcomes at 6 months. NPI has a promising diagnostic accuracy, but larger studies are warranted.
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Acta Anaesthesiol Scand · Aug 2022
International Initiation and Termination of Resuscitation Practices.
Substantial variation in survival following out-of-hospital cardiac arrest (OHCA) is described both internationally and nationally. The Utstein factors account for half of the variation, but the remaining is not fully understood. Local regulations or guidelines concerning the withholding and termination of resuscitation may influence the reporting of cardiac arrests when comparing outcomes between different Emergency Medical Service systems. ⋯ This survey could be of importance in understanding the multiple factors leading to the substantial variation in survival found following OHCA. Furthermore, the interpretation of future studies on OHCA from different settings may be improved to further increase survival following OHCA.
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Acta Anaesthesiol Scand · Aug 2022
Clinical TrialSerum concentration of oral midazolam as pediatric preanesthetic medication and factors related to sedation level.
Preanesthetic medication is important to eliminate surgical anxiety in pediatric patients and facilitate their smooth transfer to the operating room. Midazolam is the most commonly used preanesthetic medication. However, it has been reported that the sedative effect varies from patient to patient. In this study, the pharmacokinetics of midazolam were examined, and the aim was to assess the factors affecting the quality of sedation. ⋯ Clinical trial registry: UMIN R000052504.
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Acta Anaesthesiol Scand · Aug 2022
Pupil response to painful stimuli during inhalation anaesthesia without opioids in children.
Pupil dilation reflex measured by a pupillometer is known to be a useful parameter for assessing the response to perioperative noxious stimuli. In children, pupillometer can reflect changes after painful stimuli during anaesthesia or guide anaesthesia to reduce opioid consumption. However, to date, there are no data regarding pupil response during inhalation anaesthesia with analgesia by intravenous acetaminophen in children. ⋯ We suggest dilation of the pupil and decrease in NPi can indicate response to noxious stimuli in children. Regardless of sufficiency of analgesia, pupil dilation and decrease in NPi were observed after skin incision in children under general anaesthesia with 1 MAC of sevoflurane and intravenous acetaminophen.
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Acta Anaesthesiol Scand · Aug 2022
Observational StudyEpidural Analgesia and Postoperative Complications in Colorectal Cancer Surgery. An Observational Registry-based Study.
In colorectal cancer, surgical resection is fundamental for curative treatment. Epidural analgesia mitigates the perioperative physiologic stress response caused by surgery, and reduction in perioperative stress may reduce postoperative complications. Nevertheless, epidural analgesia also causes hypotension and lower limb motor weakness that can impair postoperative recovery. Here, we aimed to assess the association between epidural analgesia and postoperative complications after colorectal cancer surgery. ⋯ In total, in this observational study based on Danish registries, we found no association between epidural analgesia and postoperative complications after colorectal cancer surgery.