British journal of anaesthesia
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Randomized Controlled Trial
Influence of Bayesian optimization on the performance of propofol target-controlled infusion.
Target controlled infusion (TCI) systems use population-based pharmacokinetic (PK) models that do not take into account inter-individual residual variation. This study compares the bias and inaccuracy of a population-based vs a personalized TCI propofol titration using Bayesian adaptation. Haemodynamic and hypnotic stability, and the prediction probability of alternative PK models, was studied. ⋯ Dutch Trial Registry NTR4518.
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Randomized Controlled Trial
Gastric emptying for liquids of different compositions in children.
Pre-operative fasting balances safety against patient discomfort. We compared the gastric emptying profiles of a novel clear, high protein drink against a "traditional" clear and a non-clear fluid. ⋯ clinicaltrials.gov NCT02938065 clinicaltrials.gov/ct2/show/NCT02938065.
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Randomized Controlled Trial
Effect of gum chewing on gastric volume and emptying: a prospective randomized crossover study.
Current fasting guidelines allow oral intake of water up to 2 h before induction of anaesthesia. We assessed whether gum chewing affects gastric emptying of 250 ml water and residual gastric fluid volume measured 2 h after ingestion of water. ⋯ NCT02673307.
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The care of surgical patients with obstructive sleep apnoea (OSA) invokes concerns with safety and liability because of the risk that exists for perioperative death or near-death. The purpose of this review is to analyse the available literature to identify risk factors for perioperative critical complications in patients with OSA. Literature reports were screened for life threatening complications and deaths in surgical patients with OSA. ⋯ Eighty percent of the events occurred in the first 24 h and 67% occurred on the general hospital ward. Patients with OSA are at risk of critical complications including death during the initial 24 h after surgery. Morbid obesity, male sex, undiagnosed OSA, partially treated/untreated OSA, opioids, sedatives, and lack of monitoring are risk factors for death or near-death events.