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European Journal of Anaesthesiology

Delia Aguado, Rocío Bustamante, Ignacio A Gómez de Segura
BACKGROUND: Drugs with antagonistic actions on the Toll-like receptor 4 (Tlr4), such as naloxone at ultra low doses, have been used to inhibit opioid-induced hyperalgesia in rodents suggesting the involvement of this receptor and pathway on opioid-induced hyperalgesia. OBJECTIVE: The aim of this study was to determine whether mice without the Tlr4 gene (Tlr4) would not develop remifentanil-induced hyperalgesia. DESIGN: An experimental randomised animal study...
March 13, 2018: European Journal of Anaesthesiology
Manuel de la Matta, Alejandro Domínguez
BACKGROUND: Monitoring regional cerebral oxygen saturation (rcSO2) with near-infrared spectroscopy is increasingly being performed in patients scheduled for cardiac surgery. It is sometimes difficult to monitor both frontal lobes due to anatomical or space compromises. However, it remains unclarified whether the use of only one lateral or medial probe can provide adequate bilateral monitoring. OBJECTIVE: To evaluate the efficacy of using a single lateral or medial probe to detect substantial desaturations on both sides...
March 13, 2018: European Journal of Anaesthesiology
Matthias Vienne, Emmanuel Haas, Thibaut Wipf, Lelia Grunebaum, François Levy, Laurent Sattler, Tam Hoang Minh, François Severac, Charles Tacquard, Olivier Collange, Paul-Michel Mertes, Annick Steib
BACKGROUND: Anticoagulation during cardiopulmonary bypass (CPB) is usually adapted to total body weight (TBW). This may be inaccurate in obese patients and lead to heparin overdose with a risk of bleeding. OBJECTIVES: To validate the efficacy and safety of an adjusted calculation model of heparin dosing based on ideal body weight (IBW) rather than TBW in obese CPB patients, with an expected target mean plasma heparin concentration of 4.5 IU ml after onset of CPB in the experimental group...
March 7, 2018: European Journal of Anaesthesiology
Volker Gebhardt, Vera Zawierucha, Oliver Schöffski, Anke Schwarz, Christel Weiss, Marc D Schmittner
BACKGROUND: Both general and spinal anaesthesia with short-acting local anaesthetics are suitable and reliable for knee arthroscopy as an ambulatory procedure. Chloroprocaine (CP) 1% seems to be the ideal spinal local anaesthetic for this indication. OBJECTIVE: The aim of this study was to compare spinal anaesthesia using CP 1% with general for outpatient knee arthroscopy with regard to procedure times, occurrence of pain, patient satisfaction and recovery, and also costs...
March 7, 2018: European Journal of Anaesthesiology
Jean-Louis Vincent, Sharon Einav, Rupert Pearse, Samir Jaber, Peter Kranke, Frank J Overdyk, David K Whitaker, Federico Gordo, Albert Dahan, Andreas Hoeft
: Patient monitoring on low acuity general hospital wards is currently based largely on intermittent observations and measurements of simple variables, such as blood pressure and temperature, by nursing staff. Often several hours can pass between such measurements and patient deterioration can go unnoticed. Moreover, the integration and interpretation of the information gleaned through these measurements remains highly dependent on clinical judgement. More intensive monitoring, which is commonly used in peri-operative and intensive care settings, is more likely to lead to the early identification of patients who are developing complications than is intermittent monitoring...
February 22, 2018: European Journal of Anaesthesiology
Elisabeth A J de Vos, Yolien J Hagen, Michael I Meesters, Nada Osmanovic, Christa Boer, Marcel A de Leeuw
BACKGROUND: Procedures requiring optimisation of the coagulation status of patients using vitamin K antagonists are frequently postponed due to the late availability of laboratory international normalised ratio (INR) test results. A point-of-care (POC) alternative may facilitate early decision-making in peri-operative patients. OBJECTIVES: To assess the level of agreement between the POC-INR and the laboratory INR in patients who continue or stop vitamin K antagonists to determine whether the POC test may be a good alternative to the laboratory INR...
February 22, 2018: European Journal of Anaesthesiology
Frédéric Aubrun, Noël Zahr, Olivier Langeron, Nicolas Boccheciampe, Nathalie Cozic, Lisa Belin, Jean-Sebastien Hulot, Frederic Khiami, Bruno Riou
BACKGROUND: Among the various factors that may influence the pharmacological response to opioids, genetic polymorphisms [single nucleotide polymorphisms (SNP)] have generated some interest. OBJECTIVES: To examine the influence on morphine dose requirements and adverse events in the postoperative period of four SNP [opioid receptor mu1 (OPRM1), ATP-binding cassette subfamily B, member 1 (ABCB1) ex-21 and ex-26, catechol-o-methyltransferase (COMT)] in candidate genes involved in morphine pharmacodynamics and pharmacokinetics...
February 22, 2018: European Journal of Anaesthesiology
Sebastian Heiderich, Christian Thoben, Nils Dennhardt, Wolfgang Koppert, Terence Krauß, Robert Sümpelmann, Stefan Zimmermann, Werner Klingler
BACKGROUND: Volatile anaesthetics are a potential hazard during occupational exposure, pregnancy or in individuals with existing disposition to malignant hyperthermia. Anaesthetic waste gas concentration in postanaesthesia care units (PACU) has rarely been investigated. OBJECTIVE(S): The current study aims to assess concentrations of volatile anaesthetics in relation to room size, number of patients and ventilator settings in different PACUs. DESIGN: A prospective observational study...
February 9, 2018: European Journal of Anaesthesiology
Ashraf M Eskandr, Ahmed A Metwally, Abd-Elrahman A Ahmed, Elham M Elfeky, Islam M Eldesoky, Manar A Obada, Osama A Abd-Elmegid
BACKGROUND: During general anaesthesia, endotracheal intubation of patients with pre-eclampsia causes stimulation of the sympathetic nervous system and catecholamine release, which may lead to maternal and neonatal complications. OBJECTIVE: To attenuate both the stress response and the haemodynamic response to tracheal intubation in patients with pre-eclampsia. DESIGN: A randomised, double-blind, controlled study. SETTING: Single University Hospital...
February 9, 2018: European Journal of Anaesthesiology
Mirela Bojan, Maria C Basto Duarte, Vanessa Lopez, Laurent Tourneur, Stephanie Vicca, Marc Froissart
BACKGROUND: Earlier work on adults undergoing surgery with cardiopulmonary bypass suggests that there is a close relationship between the lower limit of the cerebral and renal autoregulation pressures. Although cerebral autoregulation during bypass in infants has been extensively investigated, the impact of bypass on kidney function is not well known. It is, nevertheless, acknowledged that the main pathophysiological process involved in cardiac surgery-related kidney damage is tubular injury, and that urine neutrophil gelatinase-associated lipocaline (uNGAL) is a reliable biomarker of injury...
February 9, 2018: European Journal of Anaesthesiology
Michaël Thy, Juliette Montmayeur, Florence Julien-Marsollier, Daphné Michelet, Christopher Brasher, Souhayl Dahmani, Gilles Orliaguet
BACKGROUND: Hydroxyethyl starch (HES) solutions have shown their efficiency for intravascular volume expansion. However, a safety recommendation limiting their use in adult patients has recently been made. The aim of this meta-analysis was to assess the efficacy and adverse effects of HES when administered intra-operatively to paediatric patients. METHODS: A search was performed for randomised controlled trials (RCTs) published before December 2016 involving paediatric patients who received 6% low molecular weight HES...
February 3, 2018: European Journal of Anaesthesiology
Nicolas Nesseler, Antoine Roquilly, Sigismond Lasocki, Claire Dahyot-Fizelier, Yoann Launey, Cinotti Raphaël, Marine Hubert, Sonia Isslame, Pierre-François Perrigault, Thomas Geeraerts, Olivier Mimoz, Fouad Marhar, Yannick Mallédant, Fanny Feuillet, Karim Asehnoune, Philippe Seguin
BACKGROUND: Knowledge of the factors associated with the decision to withdraw or withhold life support (WWLS) in brain-injured patients is limited. However, most deaths in these patients may involve such a decision. OBJECTIVES: To identify factors associated with the decision to WWLS in brain-injured patients requiring mechanical ventilation who survive the first 24 h in the ICU, and to analyse the outcomes and time to death. DESIGN: A retrospective observational multicentre study...
February 3, 2018: European Journal of Anaesthesiology
Stefanie Beck, Christian Reich, Dorothea Krause, Bjarne Ruhnke, Anne Daubmann, Jörg Weimann, Christian Zöllner, Jens Kubitz
BACKGROUND: Beginners in residency programmes in anaesthesia are challenged because working environment is complex, and they cannot rely on experience to meet challenges. During this early stage, residents need rules and structures to guide their actions and ensure patient safety. OBJECTIVE: We investigated whether self-training with an electronic audiovisual checklist app on a mobile phone would produce a long-term improvement in the safety-relevant actions during induction of general anaesthesia...
January 31, 2018: European Journal of Anaesthesiology
Ban Leong Sng, Wei Du, Man Xin Lee, Farida Ithnin, Deepak Mathur, Wan Ling Leong, Rehena Sultana, Nian-Lin R Han, Alex Tiong Heng Sia
BACKGROUND: Hypotension is a common side effect of spinal anaesthesia during caesarean delivery and is associated with maternal and foetal adverse effects. We developed an updated double intravenous vasopressor automated (DIVA) system that administers phenylephrine or ephedrine based on continuous noninvasive haemodynamic monitoring using the Nexfin device. OBJECTIVE: The aim of our present study is to compare the performance and reliability of the DIVA system against Manual Vasopressor Bolus administration...
January 25, 2018: European Journal of Anaesthesiology
Christian Bauer, Isabelle Pavlakovic, Catherine Mercier, Jean-Michel Maury, Catherine Koffel, Pascal Roy, Jean-Luc Fellahi
BACKGROUND: The benefit of adding opioid to a local anaesthetic for continuous thoracic paravertebral analgesia after video-assisted thoracic surgery (VATS) is unclear. OBJECTIVES: To analyse the analgesic efficacy of ropivacaine and sufentanil in combination compared with ropivacaine alone after VATS. DESIGN: A randomised, double-blinded, single-centre clinical trial. SETTING: A tertiary university hospital between March 2010 and April 2014...
January 25, 2018: European Journal of Anaesthesiology
Matthew A Chong, Yongjun Wang, Nicolas M Berbenetz, Ian McConachie
BACKGROUND: Much uncertainty exists as to whether peri-operative goal-directed therapy is of benefit. OBJECTIVES: To discover if peri-operative goal-directed therapy decreases mortality and morbidity in adult surgical patients. DESIGN: An updated systematic review and random effects meta-analysis of randomised controlled trials. DATA SOURCES: Medline, Embase and the Cochrane Library were searched up to 31 December 2016...
January 23, 2018: European Journal of Anaesthesiology
Andrie C Westerkamp, A Fred de Geus, Bouwe Molenbuur, Peter Meyer, J K Götz Wietasch, Michel M R F Struys, Herman G D Hendriks
BACKGROUND: Comparisons of peri-operative complications associated with paediatric (≤16 years) and adult anaesthesia are poorly available, especially in which cardiac surgery, organ transplantation and neurosurgery are involved. OBJECTIVE: The aim of this study was to evaluate the nature and incidence of peri-operative complications that might be due to anaesthesia and to identify independent risk factors for complications in children and adults, including those undergoing cardiac surgery, organ transplantation and neurosurgery...
January 13, 2018: European Journal of Anaesthesiology
Sabine Wingen, Daniel C Schroeder, Hannes Ecker, Susanne Steinhauser, Sibel Altin, Stephanie Stock, Alex Lechleuthner, Andreas Hohn, Bernd W Böttiger
BACKGROUND: Education of schoolchildren in cardiopulmonary resuscitation (CPR) is a strategic goal for improvement of bystander CPR in society. OBJECTIVE(S): The primary objective was to analyse the impact of CPR training on the resuscitation knowledge and self-confidence of secondary schoolchildren. In addition, independent predictors of improved CPR knowledge and self-confidence were investigated. DESIGN: Prospective, randomised-interventional controlled study...
January 2, 2018: European Journal of Anaesthesiology
Christina Tenedios, Sian O'Leary, Mauro Capocci, Sukumar P Desai
: Many factors determine whether nurses, physicians or both administer anaesthesia in any country. We examined the status of nurse-administered anaesthesia in the Group of 7 nations and explored how historical factors, mixing global and local contexts (such as professional relations, medical and nursing education, social status of nurses, demographics and World Wars in the 20th century), help explain observed differences. Nearly equal numbers of physicians and nurses are currently engaged in the delivery of anaesthesia care in the United States but, remarkably, although the introduction or re-introduction of nurse anaesthesia in the 20th century was attempted in all the other Group of 7 countries (except Japan), it has been successful only in France because of the cooperation with the United States during World War II...
January 2, 2018: European Journal of Anaesthesiology
Cecilia M Acosta, Tomás Sara, Martín Carpinella, Giovanni Volpicelli, Lila Ricci, Sergio Poliotto, Diego Abrego, Sergio Gonorazky, Stephan H Böhm, Gerardo Tusman
BACKGROUND: Capnoperitoneum and anaesthesia impair lung aeration during laparoscopy in children. These changes can be detected and monitored at the bedside by lung ultrasound (LUS). OBJECTIVE: The aim of our study was to assess the impact of general anaesthesia and capnoperitoneum on lung collapse and the potential preventive effect of lung recruitment manoeuvres, using LUS in children undergoing laparoscopy. DESIGN: Randomised controlled study...
December 22, 2017: European Journal of Anaesthesiology
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