BMC anesthesiology
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Lidocaine is an approved local anesthetic and Class 1B antiarrhythmic with a number of ancillary properties. Our aim was to investigate lidocaine's vasoreactivity properties in intact versus denuded rat thoracic aortic rings, and the effect of inhibitors of nitric oxide (NO), prostenoids, voltage-dependent Kv and KATP channels, membrane Na+/K+ pump, and A2a and A2b receptors. ⋯ We show that lidocaine relaxation in rat thoracic aorta was biphasic and significantly enhanced by endothelial removal, which did not appear to be NO or prostacyclin dependent. The unknown factor(s) responsible for enhanced relaxation was significantly reduced by Kv inhibition, 5-HD inhibition, and A2a subtype inhibition indicating a potential role for crosstalk in lidocaine's vasoreactivity.
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The only curative therapy for renal cell carcinoma is the complete removal of malignant tissue. Surgical bleeding during radical nephrectomy may require blood transfusion. Blood transfusion, however, is associated with postoperative morbidity and mortality. This study investigated predictive factors of transfusion requirement in patients undergoing radical nephrectomy, as well as the effects of transfusion on postoperative outcomes. ⋯ Preoperative hypoalbuminemia and anemia are important predictors of PRBC transfusion during radical nephrectomy for renal cell carcinoma. Furthermore, transfusion is associated with poor postoperative outcomes.
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Randomized Controlled Trial Retracted Publication
Dose selection of central or peripheral administration of sufentanil affect opioid induced cough?: a prospective, randomized, controlled trial.
Opioid-induced cough (OIC) is one of the most common complications of opioids during anesthesia induction. This study was designed to assess the incidence of OIC mediated by different intravenous route. ⋯ Our study indicates that sufentanil administration by central venous route reduces the incidence and severity of OIC, but without significant changes in hemodynamic status.
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The importance of optimal postoperative glycemic control in cardiac patients remains unclear. Various glycemic targets have been prescribed to reduce wound infection and overall mortality rates. ⋯ Patients with >80% TIR, whether or not diabetics, had better outcomes than those with <80% TIR, as determined by wound infection, lengths of ventilation and ICU stay. Additionally, they were not subject to frequent hypoglycemic events. Preoperatively high HbA1C is likely a good predictor of poor glycemic control.
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Observational Study
Decreased heart rate variability responses during early postoperative mobilization--an observational study.
Intact orthostatic blood pressure regulation is essential for early mobilization after surgery. However, postoperative orthostatic hypotension and intolerance (OI) may delay early ambulation. The mechanisms of postoperative OI include impaired vasopressor responses relating to postoperative autonomic dysfunction. Thus, based on a previous study on haemodynamic responses during mobilization before and after elective total hip arthroplasty (THA), we performed secondary analyses of heart rate variability (HRV) and aimed to identify possible abnormal postoperative autonomic responses in relation to postural change. ⋯ This study observed postoperative autonomic cardiovascular dysregulation that may contribute to limited HRV responses during early postoperative mobilization.