Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2012
ReviewSickle cell anaemia and the consequences on the anaesthetic management of cardiac surgery.
A review of the available literature on genetics and pathophysiology of Sickle Cell Anaemia was performed with special emphasis on the intraoperative management during cardiac surgery. Hypoxia, acidosis and hypothermia have been identified as independent sickling provoking factors. ⋯ Additionally, we bundled and reviewed the published expertise in the management of cardiopulmonary bypass and the necessity of hypothermia during cardiac surgery in Sickle Cell patients. Our conclusion is that the available data in case reports and case series on cardiac surgery in case of Sickle Cell Anaemia suggest a necessary preoperative or on bypass blood transfusion to guarantee an uncomplicated course of cardiopulmonary bypass and hypothermia.
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Acta Anaesthesiol Belg · Jan 2012
Randomized Controlled Trial Comparative StudySimilar oropharyngeal leak pressures during anaesthesia with i-gel, LMA-ProSeal and LMA-Supreme Laryngeal Masks.
We test the hypothesis that there are differences in performance among three extra-glottic airway devices during spontaneous breathing anaesthesia. ⋯ The LMA-Supreme is easier and quicker to insert than the LMA-ProSeal and i-gel using a laryngoscope-guided, gastric tube-guided technique and is associated with better anatomical positioning than the i-gel. Oropharyngeal leak pressures are similar among devices.
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Acta Anaesthesiol Belg · Jan 2012
Randomized Controlled TrialEndotracheal intubation using videolaryngoscopy causes less cardiovascular response compared to classic direct laryngoscopy, in cardiac patients according a standard hospital protocol.
Previous studies comparing Glidescope and classic direct laryngoscopy did not show an attenuation of CV responses to endotracheal intubation. In the present study, we hypothesize that indirect videolaryngoscopy can attenuate cardiovascular responses to endotracheal intubation. ⋯ Our study shows less hemodynamic responses during endotracheal intubation using indirect videolaryngoscopy compared to classic direct laryngoscopy.
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Cesarean section patients have compelling reasons to achieve optimal postoperative pain relief, because they are expected to recover expeditiously and to care for their newborns within a few hours following surgery. Consequently, it is necessary that pain relief is safe and effective, that it does not interfere with the mother's ability to care for her infant, and that it results in no adverse neonatal effects in breast-feeding women. ⋯ The aim of this manuscript is to evaluate and compare through literature review commonly used opioid- and non-opioid-based methods, when incorporated into a multimodal approach to post-caesarean pain management. Areas of promising research are also discussed.
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Acta Anaesthesiol Belg · Jan 2012
Combination of clonidine sedation and spontaneous breathing-pressure support upon acute respiratory distress syndrome: a feasibility study in four patients.
As alpha-2 agonists preserve ventilator drive, patients presenting with acute respiratory distress syndrome (ARDS, Pa02/FiO2 < 200) were managed using sedation with an alpha-2 agonist, clonidine, combined to spontaneous ventilation (SV) + pressure support ventilation (PS). ⋯ Use of an alpha-2 agonist as first-line sedative agent led to absence of respiratory depression and spontaneous ventilation. Upon ARDS, the lowered intrathoracic pressure observed with SV+PSV allowed one to recruit alveoli with high levels of PEEP, without impairing right ventricle function.