Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Dec 2005
Randomized Controlled Trial Comparative StudyProphylactic versus therapeutic administration of intravenous lidocaine for suppression of post-extubation cough following cataract surgery: a randomized double blind placebo controlled clinical trial.
Post-extubation cough causes considerable patient discomfort and in certain surgical procedures may lead to postoperative surgical complication. Different drugs and techniques have been used for the prevention of post-extubation cough with variable success rates. Prophylactic administration of lidocaine has been tried for the prevention of post-extubation cough with controversial results. No previous study has been performed to evaluate the therapeutic effect of intravenous lidocaine for treatment of post-extubation cough. This study was designed to compare the prophylactic effect of intravenous lidocaine with that of the therapeutic lidocaine in a sample of adult patients undergoing general anesthesia for cataract surgery. ⋯ The outcome of this study shows that prophylactic administration of lidocaine prior to tracheal extubation may be ineffective to prevent post-extubation cough. Based on the results of this study it can be recommended that post-extubation cough should be treated upon occurrence instead of routine prophylactic administration of lidocaine.
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Acta Anaesthesiol Taiwan · Dec 2005
Randomized Controlled TrialBolus injection of adenosine before cardioplegic induction improves postischemic global function in coronary artery bypass grafting.
Alternative strategies to optimize preexisting cardioplegia during myocardial preservation are currently under extensive investigation. Adenosine, an endogenous purine nucleoside, has been approved for its cardioprotective potential against ischemic-reperfusion injury. Yet, little information is available with respect to the use of adenosine for cardioplegic induction in humans. The purpose of the present study was, therefore, to assess the clinical relevance of intra-aortic administration of adenosine following aortic cross-clamping with respect to the exertion of additional protection in routine coronary artery bypass surgery. ⋯ Immediate administration of 250 microg/kg adenosine via the aortic root following aortic cross-clamping could optimize the myocardial protective effect of conventional cardioplegia, quicken cardiac standstill, and offer better postoperative myocardial performance after CPB.
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Acta Anaesthesiol Taiwan · Dec 2005
Cell saver does not increase pro-inflammatory cytokine levels and expression of adhesive molecules in the salvaged blood of patients undergoing off-pump coronary artery bypass surgery.
Autotransfusion has been developed to avoid the risks of contaminating with infectious diseases and susceptivity to other complications of allogeneic blood transfusion. Previous studies have shown significant pro-inflammatory cytokine release and complement activation during blood salvage with cell saver (CS) in the course of on-pump coronary artery bypass grafting (CABG) surgery. Because both extracorporeal pump and CS machine are possible to induce the adverse cytokines release, thus, in this study, we investigated the influence of CS alone on the levels of pro-inflammatory cytokines and the expression of leukocyte surface antigens in patients undergoing off-pump CABG. ⋯ Our investigation indicated that the blood processing in cell saver alone did not increase the expression of either CD11b, CD18, or CD62P, and the levels of TNF-alpha, IL-6 and IL-8. The results suggest that cell saver seems not to significantly activate the leukocytes or cause inflammatory responses in the salvaged blood.