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European Journal of Anaesthesiology

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https://www.readbyqxmd.com/read/29957706/association-between-pre-operative-biological-phenotypes-and-postoperative-pulmonary-complications-an-unbiased-cluster-analysis
#1
Ary Serpa Neto, Lieuwe D Bos, Pedro P Z A Campos, Sabrine N T Hemmes, Thomas Bluth, Carolyn S Calfee, Marion Ferner, Andreas Güldner, Markus W Hollmann, Inmaculada India, Thomas Kiss, Rita Laufenberg-Feldmann, Juraj Sprung, Demet Sulemanji, Carmen Unzueta, Marcos F Vidal Melo, Toby N Weingarten, Anita M Tuip-de Boer, Paolo Pelosi, Marcelo Gama de Abreu, Marcus J Schultz
BACKGROUND: Biological phenotypes have been identified within several heterogeneous pulmonary diseases, with potential therapeutic consequences. OBJECTIVE: To assess whether distinct biological phenotypes exist within surgical patients, and whether development of postoperative pulmonary complications (PPCs) and subsequent dependence of intra-operative positive end-expiratory pressure (PEEP) differ between such phenotypes. SETTING: Operating rooms of six hospitals in Europe and USA...
June 27, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29916859/emergence-times-and-airway-reactions-during-general-anaesthesia-with-remifentanil-and-a-laryngeal-mask-airway-a-multicentre-randomised-controlled-trial
#2
Ana Kowark, Rolf Rossaint, Friedrich Pühringer, András P Keszei, Harald Fritz, Gebhard Fröba, Christopher Rex, Hansjörg Haas, Volker Otto, Mark Coburn
BACKGROUND: Avoidance of airway complications and rapid emergence from anaesthesia are indispensable for the use of a laryngeal mask airway (LMA). Evidence from adequately powered randomised studies with a low risk of bias for the optimal anaesthetic in this context is limited. OBJECTIVE: We tested the hypothesis that when using remifentanil-based intra-operative analgesia, desflurane would be the most suitable anaesthetic: with noninferiority in the occurrence of upper airway complications and superiority in emergence times compared with sevoflurane or propofol...
June 20, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29916860/the-las-vegas-risk-score-for-prediction-of-postoperative-pulmonary-complications-an-observational-study
#3
Ary Serpa Neto, Luiz Guilherme V da Costa, Sabrine N T Hemmes, Jaume Canet, Göran Hedenstierna, Samir Jaber, Michael Hiesmayr, Markus W Hollmann, Gary H Mills, Marcos F Vidal Melo, Rupert Pearse, Christian Putensen, Werner Schmid, Paolo Severgnini, Hermann Wrigge, Marcelo Gama de Abreu, Paolo Pelosi, Marcus J Schultz
BACKGROUND: Currently used pre-operative prediction scores for postoperative pulmonary complications (PPCs) use patient data and expected surgery characteristics exclusively. However, intra-operative events are also associated with the development of PPCs. OBJECTIVE: We aimed to develop a new prediction score for PPCs that uses both pre-operative and intra-operative data. DESIGN: This is a secondary analysis of the LAS VEGAS study, a large international, multicentre, prospective study...
June 18, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29901465/diagnostic-accuracy-of-inferior-vena-caval-respiratory-variation-in-detecting-fluid-unresponsiveness-a-systematic-review-and-meta-analysis
#4
Saurabh K Das, Nang S Choupoo, Debasis Pradhan, Priyam Saikia, Xavier Monnet
BACKGROUND: The accuracy of respiratory variation of the inferior vena cava (rvIVC) in predicting fluid responsiveness, particularly in spontaneously breathing patients is unclear. OBJECTIVES: To consider the evidence to support the accuracy of rvIVC in identifying patients who are unlikely to benefit from fluid administration. DESIGN: Systematic review and meta-analysis. DATA SOURCE: We searched MEDLINE, EMBASE, Cochrane Library, KoreaMed, LILCAS and WHO Clinical Trial Registry from inception to June 2017...
June 12, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29878947/deep-neuromuscular-blockade-and-surgical-conditions-during-laparoscopic-ventral-hernia-repair-a-randomised-blinded-study
#5
Carl M Söderström, Roar Borregaard Medici, Sami Assadzadeh, Søren Følsgaard, Jacob Rosenberg, Mona R Gätke, Matias V Madsen
BACKGROUND: Laparoscopic ventral hernia repair is a common surgical procedure. However, muscle contractions and general muscle tension may impair the surgical view and cause difficulties suturing the hernial defect. Deep neuromuscular blockade (NMB) paralyses the abdominal wall muscles and may help to create better surgical conditions. OBJECTIVES: The current study investigated if deep compared with no NMB improved the surgical view during laparoscopic ventral hernia repair...
June 6, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29847363/a-comparison-of-the-incidence-of-supraventricular-arrhythmias-between-thoracic-paravertebral-and-intercostal-nerve-blocks-in-patients-undergoing-thoracoscopic-surgery-a-randomised-trial
#6
Caineng Wu, Wuhua Ma, Qingyun Cen, Qingxiang Cai, Jiyong Wang, Ying Cao
BACKGROUND: Postoperative supraventricular arrhythmias are common in patients after thoracoscopic lobectomy. Inadequate pain control has long been recognised as a significant risk factor for arrhythmias. The performance of ultrasound-guided (USG) thoracic paravertebral block (PVB) is increasing as an ideal technique for postoperative analgesia. OBJECTIVE: We conducted this study to evaluate whether a single-shot USG thoracic PVB would result in fewer postoperative supraventricular tachycardias (SVT) than intercostal nerve blocks (ICNBs) after thoracoscopic pulmonary resection...
May 29, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29847362/safety-of-moderate-to-deep-sedation-performed-by-sedation-practitioners-a-national-prospective-observational-study
#7
Lena Koers, Suzanne Eberl, Anne Cappon, Arthur Bouwman, Wolfgang Schlack, Jeroen Hermanides, Benedikt Preckel
BACKGROUND: In the Netherlands, a significant proportion of moderate-to-deep sedation is performed by sedation practitioners under the indirect supervision of an anaesthesiologist but there are limited safety data available. OBJECTIVE: To estimate the rate of sedation-related adverse events and patient relevant outcomes (PRO). DESIGN: This was a prospective national observational study. Data were collected with a modified adverse event reporting tool from the International Sedation Task Force of the World Society of Intravenous Anaesthesia...
May 29, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29794563/ultrasound-guided-single-injection-versus-continuous-sciatic-nerve-blockade-on-pain-management-and-mobilisation-after-total-knee-arthroplasty-cosinus-trial-a-randomised-triple-blinded-controlled-trial
#8
Thomas Wiesmann, Ivo Hüttemann, Nora Schilke, Thomas Heyse, Turgay Efe, Daphne Eschbach, Hinnerk Wulf, Thorsten Steinfeldt, Carsten Feldmann
BACKGROUND: Combining continuous femoral nerve blockade with single injection sciatic nerve blockade is standard peripheral nerve block practice for total knee arthroplasty (TKA) during the first 24 postoperative hours. OBJECTIVES: To assess the analgesic benefits and mobilisation capability of continuous sciatic blockade in conjunction with continuous femoral nerve blockade for 72 h after arthroplasty. DESIGN: Randomised, triple-blinded controlled trial...
May 21, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29762151/comparison-of-the-peripheral-antinociceptive-effect-of-somatostatin-with-bupivacaine-and-morphine-in-the-rodent-postoperative-pain-model
#9
Rahul Kumar, Mayank Gautam, Pranav Prasoon, Shivani Gupta, Subrata Basu Ray
BACKGROUND AND OBJECTIVES: Infiltration of surgical wound with local anaesthetics attenuate postoperative pain. However, side effects can also occur. Somatostatin (SST) and its analogues like octreotide reportedly reduce peripheral sensitisation. The current study evaluates peripherally mediated antinociceptive effect of SST in a rat model of postoperative pain. This was compared with bupivacaine and morphine under identical experimental conditions. DESIGN: Randomised vehicle-controlled blind study...
May 18, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29771733/haemodilution-and-head-down-tilting-induce-functional-injury-in-the-rat-optic-nerve-a-model-for-peri-operative-ischemic-optic-neuropathy
#10
Steven Roth, John Dreixler, Nancy J Newman
BACKGROUND: Mechanisms of peri-operative ischaemic optic neuropathy remain poorly understood. Both specific pre-operative and intra-operative factors have been examined by retrospective studies, but no animal model currently exists. OBJECTIVES: To develop a rodent model of peri-operative ischaemic optic neuropathy. In rats, we performed head-down tilt and/or haemodilution, theorising that the combination damages the optic nerve. DESIGN: Animal study...
May 15, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29750699/implementation-of-closed-loop-assisted-intra-operative-goal-directed-fluid-therapy-during-major-abdominal-surgery-a-case-control-study-with-propensity-matching
#11
Alexandre Joosten, Sean Coeckelenbergh, Amelie Delaporte, Brigitte Ickx, Jean Closset, Thierry Roumeguere, Luc Barvais, Luc Van Obbergh, Maxime Cannesson, Joseph Rinehart, Philippe Van der Linden
BACKGROUND: Goal-directed fluid therapy (GDFT) has been associated with improved patient outcomes. However, implementation of GDFT protocols remains low despite growing published evidence and the recommendations of multiple regulatory bodies in Europe. We developed a closed-loop-assisted GDFT management system linked to a pulse contour monitor to assist anaesthesiologists in applying GDFT. OBJECTIVE: To assess the impact of our closed-loop system in patients undergoing major abdominal surgery in an academic hospital without a GDFT programme...
May 9, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29750698/peri-operative-copeptin-concentrations-and-their-association-with-myocardial-injury-after-vascular-surgery-a-prospective-observational-cohort-study
#12
Firmin Kamber, Eckhard Mauermann, Esther Seeberger, Lorenz Guerke, Christian Mueller, Daniel Bolliger, Giovanna A L Lurati Buse
BACKGROUND: Copeptin levels in conjunction with cardiac troponin may be used to rule out early myocardial infarction in patients presenting with chest pain. Raised pre-operative copeptin has been shown to be associated with postoperative cardiac events. However, very little is known about the peri-operative time course of copeptin or the feasibility of very early postoperative copeptin measurement to diagnose or rule-out myocardial injury. OBJECTIVES: In this preparatory analysis for a larger trial, we sought to examine the time course of peri-operative copeptin and identify the time at which concentrations returned to pre-operative levels...
May 9, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29746373/incidence-of-akathisia-after-postoperative-nausea-and-vomiting-prophylaxis-with-droperidol-and-ondansetron-in-outpatient-surgery-a-multicentre-controlled-randomised-trial
#13
Antoine Charton, Nicolas Greib, Aude Ruimy, Valentina Faitot, Yves Noudem, Girish P Joshi, Nicolas Meyer, Pierre Diemunsch
BACKGROUND: Akathisia, a distressing movement disorder induced by butyrophenones, has been described with low doses of droperidol used for postoperative nausea and vomiting (PONV) prophylaxis, but the incidence remains unclear. OBJECTIVES: To determine the incidence of akathisia after PONV prophylaxis with two doses of droperidol in comparison with ondansetron, in patients undergoing ambulatory surgery. We hypothesised that the incidence of akathisia is higher with droperidol than that with ondansetron...
May 8, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29734208/improved-lung-recruitment-and-oxygenation-during-mandatory-ventilation-with-a-new-expiratory-ventilation-assistance-device-a-controlled-interventional-trial-in-healthy-pigs
#14
Johannes Schmidt, Christin Wenzel, Marlene Mahn, Sashko Spassov, Heidi Cristina Schmitz, Silke Borgmann, Ziwei Lin, Jörg Haberstroh, Stephan Meckel, Sebastian Eiden, Steffen Wirth, Hartmut Buerkle, Stefan Schumann
BACKGROUND: In contrast to conventional mandatory ventilation, a new ventilation mode, expiratory ventilation assistance (EVA), linearises the expiratory tracheal pressure decline. OBJECTIVE: We hypothesised that due to a recruiting effect, linearised expiration oxygenates better than volume controlled ventilation (VCV). We compared the EVA with VCV mode with regard to gas exchange, ventilation volumes and pressures and lung aeration in a model of peri-operative mandatory ventilation in healthy pigs...
May 4, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29757926/duration-of-the-action-of-rocuronium-in-patients-with-bmi-of-less-than-25-an-observational-study
#15
Osamu Takahata, Ken-Ichi Takahoko, Tomoki Sasakawa, Yasuyoshi Inagaki, Hiroyuki Takahoko, Takayuki Kunisawa
BACKGROUND: The duration of rocuronium in patients with BMI more than 30 kg m is prolonged. Whether the reverse is true when BMI is less than 18.5 kg m is unclear. OBJECTIVE: The objective of this study was to investigate whether a BMI less than 25 kg m affects the duration of rocuronium in doses adjusted for actual body weight. DESIGN: A prospective, observational, single-centre study. SETTING: The operating room of a teaching hospital from 1 June 2008 to 30 June 2015...
May 2, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29757925/a-modified-co2-o2-guedel-airway-improves-capnographic-accuracy-compared-with-a-co2-o2-nasal-cannula-an-infant-manikin-study
#16
Jens Moll, Pinelopi Anagnostopoulou, Franz J Frei, Thomas O Erb
BACKGROUND: Capnography via a CO2/O2 nasal cannula is commonly used for respiratory monitoring during sedation. However, signal disturbances are frequently encountered, especially in young children. OBJECTIVE: Sampling ports placed closer to the trachea have been shown to result in improved signal quality. In a manikin model of a 6-month-old infant we compared capnography from a modified Guedel airway with a CO2 port located at the tip with that from a CO2/O2 nasal cannula...
April 30, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29757924/placebo-versus-low-dose-ketamine-infusion-in-addition-to-remifentanil-target-controlled-infusion-for-conscious-sedation-during-oocyte-retrieval-a-prospective-double-blinded-randomised-controlled-trial
#17
Hélène I Morue, Shalini Raj-Lawrence, Sarah Saxena, Anne Delbaere, Edgard Engelman, Luc A Barvais
BACKGROUND: Currently, there is no gold standard for monitored anaesthesia care during oocyte retrieval. OBJECTIVE: In our institution, the standard is a conscious sedation technique using a target-controlled infusion (TCI) of remifentanil, titrated to maintain a visual analogue pain score less than 30 mm. This protocol is well accepted by patients but is associated with frequent episodes of respiratory depression. The main objective of this study was to evaluate whether the addition of a continuous intravenous infusion of ketamine could reduce these episodes...
April 30, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29708907/the-emergency-paediatric-surgical-airway-a-systematic-review
#18
Lena Koers, Darja Janjatovic, Markus F Stevens, Benedikt Preckel
BACKGROUND: Although an emergency surgical airway is recommended in the guidelines for a paediatric cannot intubate, cannot oxygenate (CICO), there is currently no evidence regarding the best technique for this procedure. OBJECTIVE: To review the available literature on the paediatric emergency surgical airway to give recommendations for establishing a best practice for this procedure. DESIGN: Systematic review: Considering the nature of the original studies, a meta-analysis was not possible...
April 27, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29708906/intra-operative-cutaneous-temperature-monitoring-with-zero-heat-flux-technique-3m-spoton-in-comparison-with-oesophageal-and-arterial-temperature-a-prospective-observational-study
#19
Matthieu Boisson, Anouk Alaux, Thomas Kerforne, Olivier Mimoz, Bertrand Debaene, Claire Dahyot-Fizelier, Denis Frasca
BACKGROUND: Continuous monitoring of core temperature is essential during major surgery as a way of improving patient safety. Oesophageal probes or specific arterial catheters are invasive methods used in this setting. A new noninvasive device based on zero-heat-flux (ZHF) technique (SpotOn) seems promising but has been poorly investigated during rapid core temperature changes (RCTC). OBJECTIVE: To assess the accuracy of a SpotOn sensor vs. an oesophageal probe or specific arterial catheter during a slow change in core temperature of less than 1 °C within 30 min and RCTC ≥ 1 °C within 30 min...
April 27, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29702502/peri-operative-oral-caffeine-does-not-prevent-postoperative-atrial-fibrillation-after-heart-valve-surgery-with-cardiopulmonary-bypass-a-randomised-controlled-clinical-trial
#20
David Lagier, Laetitia Nee, Régis Guieu, François Kerbaul, Emmanuel Fenouillet, Nicolas Roux, Roch Giorgi, Alexis Theron, Dominique Grisoli, Vlad Gariboldi, Frederic Collart, Nicolas Bruder, Lionel Velly, Catherine Guidon
BACKGROUND: Raised plasma levels of endogenous adenosine after cardiac surgery using cardiopulmonary bypass (CPB) have been related to the incidence of postoperative atrial fibrillation (POAF). OBJECTIVE: We wished to assess if caffeine, an adenosine receptor antagonist could have a beneficial effect on the incidence of POAF. DESIGN: A randomised controlled study. SETTING: Single University Hospital. PATIENTS: One hundred and ten patients scheduled for heart valve surgery with CPB...
April 26, 2018: European Journal of Anaesthesiology
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