British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects on coagulation of intravenous crystalloid or colloid in patients undergoing peripheral vascular surgery.
This study investigated whether haemodilution-enhanced coagulation can be demonstrated under regional anaesthesia, whether this occurs before surgery, and whether the fluid used influences the effect. ⋯ This study confirms that the enhanced perioperative coagulation mechanism is related to dilution, rather than surgery, and is triggered by rapid crystalloid haemodilution. Consideration should be given to the use of colloid rather than crystalloid solutions for rapid fluid loading in vasculopathic patients undergoing surgery.
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Randomized Controlled Trial Clinical Trial
Optimal rocuronium dose for intubation during inhalation induction with sevoflurane in children.
We studied 120 children aged 2-7 yr in a prospective, randomized, assessor-blinded fashion to define the optimal rocuronium dose which provides a 95% probability of acceptable intubation conditions (ED95TI) during inhalation induction with sevoflurane. ⋯ During inhalation induction with 8% sevoflurane in 60% nitrous oxide, rocuronium 0.29 mg kg-1 (ED95) optimizes intubation conditions for surgery of short duration.
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Randomized Controlled Trial Clinical Trial
Propofol attenuates myocardial lipid peroxidation during coronary artery bypass grafting surgery.
Propofol can scavenge free radicals because it has a chemical structure similar to antioxidants. ⋯ In clinical doses, propofol strongly attenuates lipid peroxidation during CABG surgery.
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The Brandt tracheal tube keeps cuff pressure constant during anaesthesia, but the mechanisms have not been examined. We assessed volume, pressure and gas concentration in the cuff and pilot balloon using the Brandt system. ⋯ The Brandt tracheal tube maintains stable cuff pressure during nitrous oxide anaesthesia because of a highly compliant balloon. The concentration gradient of nitrous oxide between the cuff and pilot balloon also contributes to the stable-cuff pressure because the high nitrous oxide concentration in the cuff reduces nitrous oxide influx.
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Exhaled nitric oxide (NO) concentrations have been suggested as a marker of disease onset and severity in a number of inflammatory conditions such as acute asthma. Known markers of the onset of acute lung injury require invasive tests and laboratory based analysis and have limited clinical applicability. We performed a study of the use of exhaled NO as a marker of developing acute lung injury during and after coronary artery bypass grafting in patients requiring cardiopulmonary bypass. ⋯ Further work is required to test whether exhaled NO concentration may be useful in diagnosing the onset of acute lung injury in patients undergoing coronary artery bypass grafting.