Turkish journal of anaesthesiology and reanimation
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Turk J Anaesthesiol Reanim · Aug 2019
Impact of Prehospital Mobile Intensive Care Unit Intervention on Mortality of Patients with Sepsis.
The outcome of sepsis relies on the early diagnosis and implementation of appropriate treatments. For management of out-of-hospital patients with sepsis, prehospital emergency services, named Service d'Aide Médicale d'Urgence (SAMU) in France, dispatch to the scene an emergency mobile team (EMT) or a mobile intensive care unit (MICU) based on the patient's severity. Therefore, patients are admitted to the emergency department (ED) or to the intensive care unit (ICU). The impact of MICU intervention on patient's prognosis remains unclear. The aim of the present study was to describe the impact of MICU intervention on mortality on day 28 (D28) of patients with sepsis. ⋯ We describe an association between MICU intervention and mortality on D28. MICU intervention for out-of-hospital patients with sepsis is associated with 60% reduced mortality on D28. Larger studies are needed to confirm the impact of the intervention of MICU on mortality of patients with sepsis.
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Turk J Anaesthesiol Reanim · Aug 2019
Case ReportsAnalgesia and Anaesthesia Management of Labour and Caesarean Delivery for a Parturient with Paramyotonia Congenita.
Anaesthetic management in paramyotonia congenita (PC) or 'paradoxical myotonia' poses perioperative challenges to the anaesthesiologists both in obstetric and non-obstetric surgical patients. There are only a few case reports on the anaesthesia management particularly in the obstetric population. Therefore, we aimed to present the management of analgesia of labour and emergency caesarean delivery for a 26-year-old parturient with PC.
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Turk J Anaesthesiol Reanim · Jun 2019
Case ReportsUltrasound-Guided Continuous Erector Spinae Plane Block in a Patient with Multiple Rib Fractures.
The invention of new modalities in regional anaesthesia has included a number of important fascial plane blocks. We here describe a case of a successful erector spinae plane block using a continuous catheter technique for pain relief in a patient with multiple rib fractures.
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Turk J Anaesthesiol Reanim · Jun 2019
The Effect of Sevoflurane and Dexmedetomidine on Pulmonary Mechanics in ICU Patients.
In intensive care unit (ICU) patients, intravenous (iv) and volatile agents are used for sedation. The aim of the present study was to investigate the effects of dexmedetomidine and sevoflurane on pulmonary mechanics in ICU patients with pulmonary disorders. ⋯ Both sevoflurane and dexmedetomidine are suitable sedative agents in ICU patients with pulmonary diseases.
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Turk J Anaesthesiol Reanim · Apr 2019
Influence of a Tourniquet on Opioid Consumption After Local Infiltration Analgesia for Total Knee Arthroplasty.
Local infiltration analgesia (LIA) with ropivacaine is increasingly used to provide postoperative analgesia after total knee arthroplasty (TKA). TKA may be performed with or without the use of a tourniquet. The absence of local blood flow when infiltrating local anaesthesia below an inflated tourniquet may affect the rate of systemic absorption, and this may have an effect on the duration and intensity of analgesia as compared with LIA without the use of a tourniquet. The aim of the present study was to investigate the influence of tourniquet use during surgery on the time to first request (TTFR) of opioids and opioid consumption. ⋯ There was no difference in the time to first opioid consumption, suggesting that the presence of an inflated tourniquet during local anaesthetic injection does not alter systemic absorption sufficiently to affect the duration of analgesia. However, the use of a tourniquet was associated with a higher opioid consumption, which is most likely caused by pain resulting from the tourniquet itself.