British journal of anaesthesia
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Comparative Study Observational Study
Comparison between thrombelastography and thromboelastometry in hyperfibrinolysis detection during adult liver transplantation.
Hyperfibrinolysis is one of the main causes of non-surgical bleeding during liver transplantation (LT). Viscoelastic haemostatic assays, including thromboelastometry (ROTEM(®)) and thrombelastography (TEG(®)), can detect hyperfibrinolysis at the bedside. No study has yet demonstrated which device or assay is more suitable for detecting hyperfibrinolysis. ⋯ Tissue factor-triggered ROTEM(®) tests were more sensitive than contact-activated k-TEG(®) in identifying hyperfibrinolysis in LT patients. Inhibition of platelet-fibrin interaction in FIBTEM(®) enhanced sensitivity to hyperfibrinolysis detection compared with EXTEM(®).
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Randomized Controlled Trial
Gradual withdrawal of remifentanil infusion may prevent opioid-induced hyperalgesia.
The aim of this study was to examine if gradual withdrawal of remifentanil infusion prevented opioid-induced hyperalgesia (OIH) as opposed to abrupt withdrawal. OIH duration was also evaluated. ⋯ NCT 01702389. EudraCT number 2011-002734-39.
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Randomized Controlled Trial Comparative Study
Extrafascial injection for interscalene brachial plexus block reduces respiratory complications compared with a conventional intrafascial injection: a randomized, controlled, double-blind trial†.
Hemidiaphragmatic paresis after ultrasound-guided interscalene brachial plexus block is reported to occur in up to 100% of patients. We tested the hypothesis that an injection lateral to the brachial plexus sheath reduces the incidence of hemidiaphragmatic paresis compared with a conventional intrafascial injection, while providing similar analgesia. ⋯ NCT02074397.
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Peripheral nerve stimulation is commonly used for nerve localization in regional anaesthesia, but recommended stimulation currents of 0.3-0.5 mA do not reliably produce motor activity in the absence of intraneural needle placement. As this may be particularly true in patients with diabetic neuropathy, we examined the stimulation threshold in patients with and without diabetes. ⋯ NCT01488474.