Articles: anesthetics.
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Randomized Controlled Trial Comparative Study
Comparison of the efficacy and safety of ciprofol and propofol for ERCP anesthesia in older patients: A single-center randomized controlled clinical study.
Ciprofol is a novel agonist at the gamma-aminobutyric acid-A (GABAA) receptor, exhibiting better cardiovascular stability and rapid recovery. The objective of this study was to compare the efficacy and safety of ciprofol and propofol for endoscopic retrograde cholangiopancreatography (ERCP) anesthesia in older patients. ⋯ Compared with propofol, ciprofol exhibited a comparable level of sedation in older patients undergoing ERCP, and recovery was safe and rapid with less injection pain.
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Multicenter Study Observational Study
Nitrous Oxide Manifold and Other Reduction of Emissions (NoMoreGas): a multicentre observational study evaluating pre-utilisation loss of nitrous oxide.
Nitrous oxide (N2O) is a potent greenhouse gas that contributes significantly to the healthcare sector's carbon footprint. Pre-utilisation losses of N2O are up to 95%. Decommissioning manifolds can reduce these losses. ⋯ Consistent with other reports, the data demonstrate a substantial discrepancy between the quantities of N2O procured and utilised clinically, indicative of significant pre-utilisation losses. Our findings support the decommissioning of N2O manifolds for environmental and economic benefits.
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Randomized Controlled Trial
The effects of thoracic epidural blockade on ventilation-perfusion matching during one-lung ventilation: An exploratory study.
Electrical impedance tomography (EIT) enables continuous image acquisition, facilitating real-time measurements of ventilation and perfusion at the clinical bedside. Experimental and clinical studies on controversial effects of thoracic epidural blockade (TEB) with local anesthetics on ventilation-perfusion(V/Q) matching and hypoxia during one lung ventilation (OLV) are rare. The aim of this study was to use EIT to investigate the effects of TEB combined with general anesthesia on pulmonary perfusion distribution and V/Q matching during one-lung ventilation. ⋯ Based on the contrast-enhanced EIT evaluation of pulmonary perfusion and ventilation, TEB appears to induce a V/Q mismatch in patients undergoing OLV in the lateral position for thoracic surgery.
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Randomized Controlled Trial
Impact of deep neuromuscular blockade on intraoperative NOL-guided remifentanil requirement during desflurane anesthesia in laparoscopic colorectal surgeries: A randomised controlled trial.
Evaluate the impact of deep neuromuscular blockade on intraoperative nociception Deep neuromuscular blockade has been shown to improve surgical conditions and postoperative outcomes compared to moderate neuromuscular blockade in laparoscopic surgery. Still, its impact on intraoperative nociception and opioid requirement has never been assessed. ⋯ This study shows that deep neuromuscular blockade reduces intraoperative NOL-guided administration of remifentanil in colorectal laparoscopic surgeries. It also improves surgical conditions.
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Comparative Study
Single-use synthetic plastic and natural fibre anaesthetic drug trays: a comparative life cycle assessment of environmental impacts.
Single-use anaesthetic drug trays are used widely in Australia, but their environmental impact is unclear. ⋯ Single-use trays with the lowest mass should be preferentially chosen. Recycling and composting will reduce environmental impacts. Natural fibre does not automatically confer any environmental benefit over plastic and sustainability claims should be carefully examined for accuracy. The practice of using a single-use drug tray for every procedure should be reconsidered.