British journal of anaesthesia
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Sevoflurane reduces blood pressure, the regulation of which requires an intact sympathetic neurotransmission. This study was designed to evaluate the effect of sevoflurane on the coupling between peripheral sympathetic neurones and vascular smooth muscle in isolated human omental vessels. ⋯ Sevoflurane depresses sympathetic neuromuscular transmission in human omental vessels by reducing neuronal NE release and NE sensitivity in arteries and by reducing NE release in veins. This could contribute to the hypotension seen during sevoflurane anaesthesia, at least at concentrations above 1 MAC.
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Randomized Controlled Trial Clinical Trial
Effects of dexamethasone on clinical course, C-reactive protein, S100B protein and von Willebrand factor antigen after paediatric cardiac surgery.
Anti-inflammatory treatment with glucocorticoids during cardiopulmonary bypass can reduce inflammatory mediator release, but the effects of glucocorticoid on outcome are controversial. ⋯ Administration of dexamethasone before cardiopulmonary bypass for paediatric cardiac surgery decreased the inflammatory response, but did not affect the immediate features after surgery or changes in vWf:Ag or S100B.
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Randomized Controlled Trial Clinical Trial
Sedation caused by clonidine in patients with spinal cord injury.
In patients with spinal cord injury, cephalad spread of intrathecal (i.t.) medication could be delayed. ⋯ A systemic effect is likely to be the main reason for sedation.
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In a previous study we used the bispectral index (BIS) for automatic control of propofol anaesthesia, using a proportional-integral-differential control algorithm. As control was less than optimal in some patients, we revised the constants of the control algorithm. The aim of the current study was to measure the performance of the revised system in patients undergoing minor surgery under propofol and remifentanil anaesthesia. ⋯ The system was able to provide clinically adequate anaesthesia in all patients, with better accuracy of control than in the previous study. There was a tendency for more accurate control in those patients in whom the control algorithm incorporated effect-site steering.