British journal of anaesthesia
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Randomized Controlled Trial
Efficacy of three doses of tramadol with bupivacaine for caudal analgesia in paediatric inguinal herniotomy.
This study was designed to evaluate the analgesic efficacy of three doses of tramadol, administered caudally with bupivacaine, in providing postoperative pain relief in children. ⋯ Caudal tramadol 2 mg kg(-1), combined with bupivacaine 0.25% 0.75 ml kg(-1), provided longer duration of postoperative analgesia and reduced requirement for rescue analgesic compared with tramadol 1 mg kg(-1) or 1.5 mg kg(-1) in children undergoing inguinal herniotomy.
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Multicenter Study
Perioperative fluid therapy in children: a survey of current prescribing practice.
Fluid therapy in children may be associated with iatrogenic hyponatraemia. We surveyed anaesthetists' current fluid prescribing practice during the perioperative period, departmental fluid protocols and awareness of the concerns of the Royal College of Paediatrics and Child Health (RCPCH) about the use of dextrose 4%/saline 0.18% in children. ⋯ The prescription of hypotonic dextrose saline solutions by anaesthetists may be putting children at risk from iatrogenic hyponatraemia. Departmental protocols for perioperative fluid prescription in children are uncommon. We suggest that national guidance is required.
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Sevoflurane protects the myocardium against ischaemic injury through protein kinase C (PKC) activation, mitochondrial K+ATP-channel (mitoK+ATP) opening and production of reactive oxygen species (ROS). However, it is unclear whether the type of ischaemia determines the involvement of these signalling molecules. We therefore investigated whether hypoxia (HYP) or metabolic inhibition (MI), which differentially inhibit the mitochondrial electron transport chain (ETC), are comparable concerning the relative contribution of PKC, mitoK+ATP and ROS in sevoflurane-induced cardioprotection. ⋯ PKC, mitoK+ATP and ROS are involved in sevoflurane-induced cardioprotection after HYP or MI, suggesting that the means of mitochondrial ETC inhibition does not determine the signal transduction pathway for cardioprotection by anaesthetics.
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Randomized Controlled Trial
Correlation and agreement between bispectral index and state entropy of the electroencephalogram during propofol anaesthesia.
Bispectral index (BIS) and state entropy (SE) monitor hypnosis. We evaluated the correlation and the agreement between those parameters during propofol anaesthesia and laryngoscopy with and without muscle relaxation. ⋯ BIS and SE are globally well correlated. In contrast, agreement is poor as differences of more than 20 units are frequently observed, except for awake and paralysed patients.
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Randomized Controlled Trial
Intra-articular magnesium is effective for postoperative analgesia in arthroscopic knee surgery.
Several medications are commonly injected intra-articularly for postoperative analgesia after arthroscopic knee surgery. Among the potentially efficient substances, magnesium could be of particular interest through its NMDA-receptor blocking properties. ⋯ Intra-articular magnesium is effective for postoperative analgesia in arthroscopic knee surgery.