British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Sevoflurane and propofol decrease intraocular pressure equally during non-ophthalmic surgery and recovery.
To provide good control of intraocular pressure (IOP) during anaesthesia and surgery, we conducted a study comparing the effects on IOP during maintenance and recovery of sevoflurane vs propofol anaesthesia in 33 patients (ASA I-II) undergoing elective non- ophthalmic surgery. ⋯ Sevoflurane maintains the IOP at an equally reduced level compared with propofol.
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Randomized Controlled Trial Clinical Trial
Effects of a new modified, balanced hydroxyethyl starch preparation (Hextend) on measures of coagulation.
Hydroxyethyl starch (HES) may affect blood coagulation. We studied the effects of a modified, balanced, high-molecular weight [mean molecular weight (MW) 550 kDa], high-substituted [degree of substitution (DS) 0.7] HES preparation (Hextend) on coagulation in patients undergoing major abdominal surgery. ⋯ A modified, balanced high-molecular weight HES with a high degree of substitution (Hextend) adversely affected measures of coagulation in patients undergoing major abdominal surgery, whereas a preparation with a low MW and low DS affected these measures of haemostasis less. Large amounts of RL decreased the coagulation time.
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We present three cases of epidural abscess, all in patients in whom an epidural catheter had been inserted for postoperative pain management. In all three cases the infecting organism was Staphylococcus aureus and two patients had diabetes. ⋯ We have retrospectively calculated the incidence of epidural abscess in our hospital over the 5-yr period 1993-98 to be 1 in 800 (0.12%). We emphasize the importance of using techniques that minimize the risk of bacterial contamination during both catheter placement and the management of infusion, and seek to raise awareness of this relatively rare but significant condition.
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Several attempts have been made to evaluate patients' concerns with respect to postoperative recovery. To identify aspects of postoperative recovery relevant to patients, several methodological and statistical approaches have been used. One of the first to provide useful information was Fredrick Orkin who used conjoint analysis. This methodology is usually performed by market researchers to learn about the relative importance of product attributes. We used conjoint analysis in the present study. ⋯ Avoidance of PONV is a major concern for patients before surgery.