British journal of anaesthesia
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Randomized Controlled Trial
Effect of an intubation dose of rocuronium on Spectral Entropy and Bispectral Index responses to laryngoscopy during propofol anaesthesia.
The spectral entropy of the electroencephalogram has been proposed to monitor the depth of anaesthesia. State Entropy (SE) reflects the level of hypnosis. Response Entropy (RE), computed from electroencephalogram and facial muscle activity, reflects the response to nociceptive stimulation. We evaluated the effect of rocuronium on Bispectral Index (BIS) and entropy responses to laryngoscopy. ⋯ Rocuronium alters the RE-SE gradient and the RE and RE-SE responses to laryngoscopy. Muscle relaxation may confound interpretation of entropy monitoring.
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Randomized Controlled Trial
The effects of propofol on neutrophil function, lipid peroxidation and inflammatory response during elective coronary artery bypass grafting in patients with impaired ventricular function.
Coronary artery bypass grafting (CABG) with cardiopulmonary bypass elicits a potent reperfusion injury and inflammatory response, more intense in patients with impaired myocardial function. Propofol has antioxidant properties which may attenuate such a response. ⋯ Propofol attenuates free-radical-mediated lipid peroxidation and systemic inflammation in patients with impaired myocardial function undergoing CABG.
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Randomized Controlled Trial
A prospective, double-blind, randomized trial of caudal block using ropivacaine 0.2% with or without fentanyl 1 microg kg-1 in children.
It has been reported that ropivacaine produces vasoconstriction in contrast to vasodilation produced by bupivacaine. It is possible that additives to ropivacaine can provide further analgesic advantages compared with bupivacaine. We thus evaluated whether the addition of fentanyl to ropivacaine prolonged the duration of analgesia after a single shot caudal block. ⋯ We found that the addition of fentanyl 1 mug kg(-1) to ropivacaine 0.2% for caudal analgesia provides no further analgesic advantages over ropivacaine 0.2% alone.
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Randomized Controlled Trial
Do we need inhaled anaesthetics to blunt arousal, haemodynamic responses to intubation after i.v. induction with propofol, remifentanil, rocuronium?
The aim of this study was to determine whether, after propofol, rocuronium and remifentanil rapid sequence induction, inhaled anaesthetic agents should be started before intubation to minimize autonomic and arousal response during intubation. ⋯ Desflurane and sevoflurane were unable to blunt the arousal reflex completely, as measured by BIS, although the reflex was significantly less when desflurane was used. Rapid sequence induction with remifentanil, propofol and rocuronium and without inhaled anaesthetics before intubation can be done without dangerous haemodynamic and arousal responses at intubation after 90 s.
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Randomized Controlled Trial
Lack of renoprotective effect of i.v. N-acetylcysteine in patients with chronic renal failure undergoing cardiac surgery.
Pre-existing chronic renal failure is a significant risk factor for acute renal failure (ARF) after cardiac surgery. N-acetylcysteine (NAC) has been shown to prevent contrast media-induced ARF. Our objective was to evaluate whether i.v. NAC has renoprotective effects in patients with mild renal failure undergoing cardiac surgery. ⋯ Prophylactic treatment with i.v. N-acetylcysteine had no renoprotective effect in patients with pre-existing renal failure undergoing cardiac surgery.