British journal of anaesthesia
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Observational Study
Respiratory stroke volume variation assessed by oesophageal Doppler monitoring predicts fluid responsiveness during laparoscopy.
This study was designed to assess the ability of the stroke volume respiratory variation (ΔrespSV) determined by oesophageal Doppler monitoring (ODM) to predict the response to volume expansion (VE) during pneumoperitoneum. The predictive value of ΔrespSV was evaluated according to the concept of the 'grey zone'. ⋯ ΔrespSV and ΔrespPV predicted fluid responsiveness during laparoscopy under strict physiological conditions. FTc was not predictive of fluid responsiveness during laparoscopy.
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The use of lipid emulsions to reduce cardiac toxicity of local anaesthetics (LAs) has shown success in experimental studies and some clinical cases, and thus has been implemented in clinical practice. However, lipid treatment is usually given after the occurrence of neurological or cardiovascular symptoms of systemic intoxication. The aim of this study was to determine if pretreatment with lipid emulsion reduces cardiac toxicity produced by bupivacaine or mepivacaine. ⋯ This study confirms that pretreatment with a lipid emulsion reduces cardiac toxicity of LAs. The efficacy of pretreatment with lipid emulsion was LA-dependent, so pharmacokinetic properties, such as lipophilicity, might influence the effects of lipid emulsion pretreatment.