Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 2019
Randomized Controlled Trial Multicenter StudyPantoprazole in ICU patients at risk for gastrointestinal bleeding - one-year mortality in the SUP-ICU trial.
The long-term effects of stress ulcer prophylaxis with pantoprazole are unknown in ICU patients. We report 1-year mortality outcome in the Stress Ulcer Prophylaxis in the Intensive Care Unit (SUP-ICU) trial. ⋯ We did not observe a difference in 1-year mortality among acutely admitted adult ICU patients with risk factors for gastrointestinal bleeding allocated to stress ulcer prophylaxis with pantoprazole or placebo during the ICU stay. (The SUP-ICU trial was funded by Innovation Fund Denmark and others; ClinicalTrials.gov number, NCT02467621).
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Acta Anaesthesiol Scand · Oct 2019
Randomized Controlled TrialIntraoperative methadone for postoperative pain after laparoscopic hysterectomy: Protocol for a randomised, double-blind trial.
Hysterectomy is often carried out as same-day surgery. Treatment of postoperative pain is, therefore, of utmost importance to ensure timely discharge from hospital. Methadone has several desirable pharmacological features, including a long elimination half-life. Theoretically, a single intraoperative dose could provide long-lasting pain relief. ⋯ The study outlined in this protocol will provide important information about the use of methadone in same-day hysterectomy patients. The results will presumably be applicable to other types of surgery involving visceral pain.
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Acta Anaesthesiol Scand · Oct 2019
Randomized Controlled Trial Multicenter Study Observational StudyCerebrovascular autoregulation following cardiac arrest: protocol for a post hoc analysis of the randomized COMACARE pilot trial.
Approximately two-thirds of the mortality following out of hospital cardiac arrest is related to devastating neurological injury. Previous small cohort studies have reported an impaired cerebrovascular autoregulation following cardiac arrest, but no studies have assessed the impact of differences in oxygen and carbon dioxide tensions in addition to mean arterial pressure management. ⋯ Cerebrovascular autoregulation is critical to maintain homoeostatic brain perfusion. This study of changes in autoregulation following out of hospital cardiac arrest over the first 48 hours, as compared to data from healthy volunteers, will generate important physiological information that may guide the rationale and design of interventional studies.
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Acta Anaesthesiol Scand · Oct 2019
Randomized Controlled TrialAre single-injection erector spinae plane block and multiple-injection costotransverse block equivalent to thoracic paravertebral block?
Thoracic paravertebral block (TPVB) is considered the gold standard for hemithoracic regional anaesthesia. Erector spinae plane block (ESPB) is a new posterior thoracic wall block. Multiple-injection costotransverse block (MICB) mimics TPVB but with injection points within the thoracic intertransverse tissue complex and posterior to the superior costotransverse ligament. We aimed to compare the spread of injectate into the thoracic paravertebral space (TPVS) resulting from single-injection ESPB and MICB, respectively, with TPVB. ⋯ Consistent spread of dye into the TPVS colouring the ventral rami, the communicating rami, and the sympathetic trunk was observed with MICB; in this respect equivalent to TPVB. ESPB exhibited only partial success and was not equivalent to TPVB. No epidural spread was found with neither MICB nor ESPB.
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Acta Anaesthesiol Scand · Oct 2019
Randomized Controlled TrialInhaled prostacyclin for the prevention of increased pulmonary vascular resistance in cemented hip hemiarthroplasty-A randomised trial.
Bone cementation may cause pulmonary vasoconstriction and ventilation/perfusion abnormalities in patients undergoing cemented hip hemiarthroplasty. In this randomised trial, we tested the hypothesis that intra-operative inhalation of prostacyclin could attenuate the increase in pulmonary vascular resistance index (PVRI, primary endpoint) when compared to inhaled saline in this group of patients. ⋯ Inhalation of prostacyclin attenuates the increase in pulmonary vascular resistance in patients undergoing cemented hip hemiarthroplasty and could potentially attenuate/prevent haemodynamic instability induced by an increase in right ventricular afterload seen in this procedure.