British journal of anaesthesia
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There is renewed interest in the use of induced hypothermia as a method of neuroprotection both intraoperatively and in the intensive care management of severe brain injury. In this study we have investigated the effects of hypothermia on brain tissue oxygenation in patients with severe head injury. ⋯ These results emphasize the advantage of measuring brain temperature directly, and suggest that decreasing brain temperature below 35 degrees C may impair brain tissue oxygenation.
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Safe care of sedated children requires ongoing assessment of the depth of sedation to permit early recognition of progression to over-sedation. This study evaluated the validity and reliability of the University of Michigan Sedation Scale (UMSS) as a measure of sedation during procedures. The UMSS is a simple observational tool that assesses the level of alertness on a five-point scale ranging from 1 (wide awake) to 5 (unarousable with deep stimulation). ⋯ The UMSS is a simple, valid and reliable tool that facilitates rapid and frequent assessment and documentation of depth of sedation in children.
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The importance of molecular shape and electrostatic potential in determining the activities of 11 structurally-diverse i.v. general anaesthetics was investigated using computational chemistry techniques. ⋯ The results demonstrate that a single activity model can be formulated for chiral and non-chiral i.v. anaesthetic agents using molecular similarity indices.
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The accuracy of the bispectral index (BIS) as a monitor of consciousness has not been well studied in patients who have abnormal electroencephalograms (EEG). ⋯ Post-ictal slow-wave activity in the EEG (acting via the SynchFastSlow subparameter) may cause low BIS values that do not correspond to the patient's clinical level of consciousness. This may be important in the interpretation of the BIS in other groups of patients who have increased delta-band power in their EEG.