British journal of anaesthesia
-
Randomized Controlled Trial Clinical Trial
Dexamethasone decreases the pro- to anti-inflammatory cytokine ratio during cardiac surgery.
Cytokines regulate inflammation associated with cardiopulmonary bypass (CPB). Pro-inflammatory cytokines may cause myocardial dysfunction and haemodynamic instability after CPB, but the release of anti-inflammatory cytokines is potentially protective. We studied the effects of dexamethasone on pro- and anti-inflammatory cytokine responses during coronary artery bypass grafting surgery. ⋯ Dexamethasone given before cardiac surgery changes circulating cytokines in an anti-inflammatory direction. Postoperative outcome may be improved by inhibition of the systemic inflammatory response.
-
With the increasing number of critically ill patients, and shortage of intensive care unit and ward beds, some postoperative patients stay for an unnecessarily long period in the postanaesthesia care unit (PACU), until a suitable bed is available. ⋯ Patient overflow to the PACU is a common problem that requires attention. Guidelines for medical and nursing coverage, patient triage, and communication with relatives need to be outlined.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Radial artery cannulation: topical amethocaine gel versus lidocaine infiltration.
In a prospective randomized study, we compared topical 4% amethocaine gel (Ametop) with 2% lidocaine infiltration for analgesia for radial artery cannulation. A previous study had shown topical analgesia with EMLA cream reduced pain, shortened cannulation time, and improved success rates when compared with lidocaine infiltration. ⋯ There was no significant difference between these two methods of analgesia for any measured variable.
-
Randomized Controlled Trial Clinical Trial
Effect of perioperative administration of dexketoprofen on opioid requirements and inflammatory response following elective hip arthroplasty.
In this double-blind, randomized, placebo-controlled trial, the safety and analgesic efficacy of perioperative dexketoprofen were evaluated. ⋯ Perioperative administration of dexketoprofen 25 mg 8 hourly markedly improves analgesia and decreases opioid requirements (and associated adverse effects) following hip arthroplasty. It appears that this regimen decreases the postoperative pro-inflammatory response.