British journal of anaesthesia
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Randomized Controlled Trial
Phenylephrine impairs host defence mechanisms to infection: a combined laboratory study in mice and translational human study.
Immunosuppression after surgery is associated with postoperative complications, mediated in part by catecholamines that exert anti-inflammatory effects via the β-adrenergic receptor. Phenylephrine, generally regarded as a selective α-adrenergic agonist, is frequently used to treat perioperative hypotension. However, phenylephrine may impair host defence through β-adrenergic affinity. ⋯ NCT02675868 (Clinicaltrials.gov).
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Randomized Controlled Trial
Propofol plus low dose dexmedetomidine infusion and postoperative delirium in older patients undergoing cardiac surgery.
Postoperative delirium (POD) is a frequent complication in older patients. Dexmedetomidine might be effective in decreasing the incidence of POD. We hypothesised that adding low-dose rate dexmedetomidine infusion to a propofol sedation regimen would have fewer side-effects and would counteract the possible delirium producing properties of propofol, resulting in a lower risk of POD than propofol with placebo. ⋯ NCT03388541.
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Randomized Controlled Trial
Perioperative use of physostigmine to reduce opioid consumption and peri-incisional hyperalgesia: a randomised controlled trial.
Several studies have shown that cholinergic mechanisms play a pivotal role in the anti-nociceptive system by acting synergistically with morphine and reducing postoperative opioid consumption. In addition, the anti-cholinesterase drug physostigmine that increases synaptic acetylcholine concentrations has anti-inflammatory effects. ⋯ EudraCT number 2012-000130-19.