British journal of anaesthesia
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One major risk factor of the sitting position for neurosurgery is air embolism, especially in patients with persistent foramen ovale (PFO). The first aim of this prospective study was to evaluate a bedside method for detecting PFO using transcranial Doppler sonography (TCD) with contrast medium. A second aim was to address intraoperative monitoring, patient positioning and the occurrence and clinical relevance of air embolism. ⋯ To address the risk of a paradoxical air embolism, especially in patients undergoing surgery in sitting position, preoperative detection of PFO is advisable. If surgery is performed in seated PFO patients, additional monitoring and special care are warranted.
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Randomized Controlled Trial Comparative Study
A comparison of patient-controlled subacromial and i.v. analgesia after open acromioplasty surgery.
The aim of this study was to compare three patient-controlled analgesia (PCA) techniques for pain relief after acromioplasty. These techniques included use of subacromial ropivacaine, subacromial fentanyl or i.v. fentanyl. ⋯ The PCA techniques using subacromial ropivacaine or fentanyl i.v. provided similar and adequate pain relief and minimal side-effects after open acromioplasty surgery. The PCA using subacromial fentanyl was not as effective as either subacromial ropivacaine or i.v. fentanyl.