Der Anaesthesist
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Randomized Controlled Trial
[Removal of the laryngeal mask airway in the post-anesthesia care unit. A means of process optimization?].
Removal of the laryngeal mask airway in the post-anesthesia care unit could potentially contribute to a faster turnover from one operation to the next. The aim of this study was, therefore, to obtain an insight into the potential time saving and the safety of planned removal of the ProSeal™-LMA (PLMA) in the post-anesthesia care unit. ⋯ Planned PLMA removal in the recovery room after BIS-guided balanced anesthesia did not enable the anesthetist to be available earlier for induction of anesthesia in the following patient. Hence the anesthetist could not contribute to a faster turnover of cases. Obviously, with the type of close communication between surgeon and anesthetist dictated by the study protocol (announcement of expected end of surgery by the surgeon 20 min before end of surgery) it is possible for the patient to regain consciousness within a very small time window following the end of surgery. Following this kind of protocol, postponement of removal of the LMA in the recovery room does not seem to be attractive neither from a clinical nor an economic point of view. In contrast, removal of LMA in the recovery room should be restricted to occasional cases with an abrupt end of the operation or prolonged emergence from anesthesia. The obvious risk of hypoxemia necessitates continuous O(2) application and S(p)O(2) monitoring during transport to the recovery room.
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Randomized Controlled Trial
Pharmacokinetics of propofol in patients undergoing total hip replacement : effect of acute hypervolemic hemodilution.
The aim of the study was to investigate the effects of acute hypervolemic hemodilution (HHD) on the pharmacokinetics of propofol in patients undergoing total hip replacement. ⋯ Acute HHD increases V(C), prolongs the T(1/2) (γ), and decreases K(10) and CL, which suggests that care must be taken when propofol is used in patients undergoing HHD. The induction dose should be increased, but the maintenance dose should be decreased. The time to emergency from anesthesia will likely be prolonged, especially in patients receiving prolonged continuous infusions.
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Randomized Controlled Trial
External chest compressions using a mechanical feedback device : cross-over simulation study.
External chest compressions (ECC) are essential components of resuscitation and are usually performed without any adjuncts in professional healthcare. Even for healthcare professionals during in-hospital and out-of-hospital resuscitation poor performance in ECC has been reported in recent years. Although several stand-alone devices have been developed none has been implemented as a standard in patient care. The aim of this study was to examine if the use of a mechanical device providing visual feedback and audible assistance during ECC improves performance of healthcare professionals following minimal and simplified instructions. ⋯ The tested device is easy to use after instruction of less than 3 min and improves ECC performance of healthcare professionals in simulated cardiac arrest with respect to compression depth as well as compression rate.
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Randomized Controlled Trial Comparative Study
Different anesthesia methods for laparoscopic cholecystectomy.
The aim of the study was to compare the possibility of performing laparoscopic cholecystectomy using two different anesthesia procedures (spinal anesthesia versus general anesthesia). ⋯ Laparoscopic cholecystectomy with low pressure pneumoperitoneum with CO(2) can be safely performed under spinal anesthesia. Spinal anesthesia was associated with an extremely low level of postoperative pain, better recovery and lower cost than general anesthesia.
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Randomized Controlled Trial
[Tonsillotomy and adenotonsillectomy in childhood. Study on postoperative pain therapy].
The primary aim of this study was to determine whether the combination of i.v. ketoprofen and i.v. paracetamol provides superior postoperative analgesia in children undergoing adenoidectomy or tonsillotomy compared to either drug alone. The secondary goal was to assess the time until rescue analgesia was needed, propofol requirements and the incidence of vomiting and time of discharge from the postanaesthesia recovery unit (PARU). ⋯ The combination of i.v. paracetamol and i.v. ketoprofen provides superior postoperative analgesia compared to the single use of paracetamol.