British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Sequential compression device with thigh-high sleeves supports mean arterial pressure during Caesarean section under spinal anaesthesia.
This study investigated the use of a Sequential Compression Device (SCD) with thigh-high sleeves and a preset pressure of 50 mm Hg that recruits blood from the lower limbs intermittently, as a method to prevent spinal hypotension during elective Caesarean section. Possible association of arterial pressure changes with maternal, fetal, haemodynamic, and anaesthetic factors were studied. ⋯ SCD use in conjunction with vasopressor significantly reduced the incidence of a 20% reduction of MAP.
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We report two cases who exhibited a decrease in their bispectral index (BIS) score, associated with syncope during venipuncture in patients with suspected needle phobia. In case 1, the reduction in BIS score occurred during the development of hypotension and bradycardia and may well have been caused by cerebral hypoperfusion. In case 2, the patient lost consciousness with decreasing BIS score before hypotension and bradycardia; this patient's condition could not be completely explained by cerebral hypoperfusion as a result of a vasovagal reflex because the patient's blood pressure and heart rate remained normal during the syncopal episode.
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Randomized Controlled Trial Clinical Trial
Effect of adding dopexamine to intraoperative volume expansion in patients undergoing major elective abdominal surgery.
The contribution of low-dose dopexamine to outcome, when given to increase cardiac output in patients already treated with fluids during major abdominal surgery, is not yet known. ⋯ We could not demonstrate an advantage to using low-dose dopexamine in high-risk patients during major abdominal surgery.
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Pulse transit time (rPTT), the interval between ventricular electrical activity and arrival of a peripheral pulse waveform, has been used to detect changes in autonomic tone. The aim of this observational pilot study was to measure changes in rPTT in response to general anaesthesia and noxious stimuli. ⋯ Variation in rPTT reflects autonomic responses to nociceptive stimulation and fluctuations in anaesthetic depth independently of heart rate.
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Perfluorocarbon (PFC) has been widely used in the treatment of respiratory diseases; however, PFC content of the breathing gases remains unknown. Therefore, we developed an absorber using PFC selective zeolites for PFC measurement in gases and investigated its accuracy. ⋯ This zeolite absorber is an accurate method to quantitatively determine PFC in breathing gases and can be used as a reference method to validate other PFC sensors.