British journal of anaesthesia
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Randomized Controlled Trial
Effect of intravenous fluid therapy on postoperative vomiting in children undergoing tonsillectomy.
Postoperative vomiting (POV) is one of the most frequent complications of tonsillectomy in children. The aim of this study was to evaluate the antiemetic effect of super-hydration with lactated Ringer's solution in children undergoing elective otorhinolaryngological surgery. ⋯ Intraoperative administration of 30 ml kg(-1) h(-1) lactated Ringer's solution significantly reduced the incidence of POV during the first 24 h postoperative. Our results support the use of super-hydration during tonsillectomy, as an alternative way to decrease the risk of POV in children.
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Patients undergoing emergency surgery continue to be at very high risk, but accurate risk identification for the individual patient remains difficult. This study tested the usefulness of perioperative N-terminal pro B-type natriuretic peptide (NT-proBNP) for in-hospital and long-term risk stratification. ⋯ Preoperative NT-proBNP can help identify patients at high risk for adverse long-term outcome after emergency surgery.
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Randomized Controlled Trial
Surgical pleth index-guided remifentanil administration reduces remifentanil and propofol consumption and shortens recovery times in outpatient anaesthesia.
The surgical pleth index (SPI) is an index based on changes in plethysmographic characteristics that correlate with the balance between the sympathetic and parasympathetic nervous system. It has been proposed as a measure of the balance between nociception and anti-nociception. The goal of this study was to test whether it could be used to titrate remifentanil in day-case anaesthesia. ⋯ Adjusting the remifentanil dosage according to the SPI in outpatient anaesthesia reduced the consumption of both remifentanil and propofol and resulted in faster recovery.