British journal of anaesthesia
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Case Reports
Ultrasound-guided lumbar plexus block through the acoustic window of the lumbar ultrasound trident.
Lumbar plexus block (LPB) is frequently used in combination with an ipsilateral sacral plexus or sciatic nerve block for lower limb surgery. This is traditionally performed using surface anatomical landmarks, and the site for local anaesthetic injection is confirmed by observing quadriceps muscle contraction to peripheral nerve stimulation. In this report, we describe a technique of ultrasound-guided LPB that was successfully used, in conjunction with a sciatic nerve block, for anaesthesia during emergency lower limb surgery. The anatomy, sonographic features, technique of identifying the lumbar plexus, and the potential benefits of using this approach are discussed.
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Comparative Study
Cardiac output measurement in children: comparison of Aesculon cardiac output monitor and thermodilution.
We compared cardiac output (CO) measurements by the non-invasive electrical velocimetry (Aesculon) monitor with the pulmonary artery catheter (PAC) thermodilution method in children. ⋯ Electrical velocimetry using the Aesculon monitor did not provide reliable CO values when compared with PAC thermodilution. Whether the Aesculon monitor can be used as a CO trend monitor has to be assessed by further investigations in patients with changing haemodynamics.
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Randomized Controlled Trial
Effects of short-term simultaneous infusion of dobutamine and terlipressin in patients with septic shock: the DOBUPRESS study.
Terlipressin bolus infusion may reduce cardiac output and global oxygen supply. The present study was designed to determine whether dobutamine may counterbalance the terlipressin-induced depression in mixed-venous oxygen saturation (Svo) in patients with catecholamine-dependent septic shock. ⋯ In human catecholamine-dependent septic shock, terlipressin (with and without concomitant dobutamine infusion) increases MAP and markedly reduces norepinephrine requirements. Although no adverse events were noticed in the present study, potential benefits of increasing Svo2 after terlipressin bolus infusion need to be weighted against the risk of cardiovascular complications resulting from high-dose dobutamine.
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Randomized Controlled Trial Comparative Study
Comparison of the effects of gelatin and a modern hydroxyethyl starch solution on renal function and inflammatory response in elderly cardiac surgery patients.
The effects of hydroxyethylstarch (HES) 130/0.4 6% and gelatin 4% on inflammation, endothelial integrity, and renal function after cardiac surgery were compared. ⋯ In cardiac surgery patients aged >80 years, volume therapy with HES 130/0.4 6% was associated with less marked changes in kidney function and a less marked endothelial inflammatory response than gelatin 4%.