Annals of cardiac anaesthesia
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Randomized Controlled Trial
Comparison of postoperative delirium within 24 hours between ketamine and propofol infusion during cardiopulmonary bypass machine: A randomized controlled trial.
Postoperative delirium (POD) is a common complication in cardiac surgery especially in elderly population which can lead to a delay of weaning from ventilator and extubation. Cardiopulmonary bypass (CPB)-induced inflammation is related to POD. Anti-inflammatory effect of anesthetic agent might attenuate POD. ⋯ With limitations of the study, prevention of 24-h POD in general by ketamine was inconclusive. In comparison with propofol, ketamine leaded to less events of 24-h POD and kept higher MAP. Severity of postoperative inflammation was a significant prediction of 24-h POD.
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Randomized Controlled Trial Comparative Study
Comparison of pectoral Nerve (PECS1) block with combined PECS1 and transversus thoracis muscle (TTM) block in patients undergoing cardiac implantable electronic device insertion - A pilot study.
Pectoral nerve (PECS1) block has been used for patients undergoing cardiac implantable electronic device (CIED) insertions, however, PECS1 block alone may lead to inadequate analgesia during tunneling and pocket creation because of the highly innervated chest wall. Transversus thoracis muscle plane (TTM) block targeting the anterior branches of T2-T6 intercostal nerves can be effectively used in combination with PECS1 for patients undergoing CIED insertion. The present study hypothesized that combined PECS1 and TTM blocks would provide effective analgesia for patients undergoing CIED insertion compared to PECS1 block alone. ⋯ Combined PECS1 and TTM blocks provide superior analgesia, reduced net consumption of local anesthetic, sedative agents, and rescue analgesics compared to PECS1 block alone in patients undergoing CIED insertion.
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Randomized Controlled Trial
Combined effect of left stellate ganglion blockade and topical administration of papaverine on left internal thoracic artery blood flow in patients undergoing coronary revascularization.
Left stellate ganglion blockade (LSGB) may have additive effect to topical administration of papaverine on prevention of vasospasm of left internal thoracic artery (LITA). ⋯ Combining LSGB with papaverine does not increase the LITA blood flow compared to when the papaverine is used alone. However, ganglion blockade reduces radial-femoral arterial pressure difference after CPB. Blockade can be achieved successfully under the ultrasound guidance without any complications.
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Randomized Controlled Trial Comparative Study
Comparative evaluation of hemodynamic responses and ease of intubation with airtraq video laryngoscope versus macintosh laryngoscope in patients with ischemic heart disease.
Hemodynamic responses during laryngoscopy can potentially precipitate ischemia in patients with coronary artery disease. There are conflicting reports regarding the hemodynamic stress responses between the conventional Macintosh and video laryngoscopes. There is a paucity of studies regarding the same in cardiac surgical patients. ⋯ Airtraq provides the better hemodynamic stability and ease of intubation and may be considered superior to conventional Macintosh laryngoscope for intubation in patients with ischemic heart disease.
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Randomized Controlled Trial Comparative Study
A comparative study of safety and efficacy of ultrasound-guided infra-clavicular axillary vein cannulation versus ultrasound-guided internal jugular vein cannulation in adult cardiac surgical patients.
Ultrasound (US)-guided internal jugular vein (IJV) cannulation is a widely accepted standard procedure. The axillary vein (AV) in comparison to the subclavian vein is easily visualized, but its cannulation is not extensively studied in cardiac patients. ⋯ The study shows that the US-guided AV cannulation may serve as an effective alternative to the IJV cannulation in cardiac surgery.