Acta anaesthesiologica Taiwanica : official journal of the Taiwan Society of Anesthesiologists
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Acta Anaesthesiol Taiwan · Sep 2011
The effect on improvement of recovery and pain scores of paravertebral block immediately before breast surgery.
Paravertebral block (PVB) has the potential to reduce postoperative pain after breast surgery. The aim of the study was to investigate whether PVB performed immediately before surgery could affect the postoperative morbidities in terms of pain and emesis, and improve the quality of recovery (QoR) in patients after surgery for breast cancer. ⋯ PVB given before surgery in combination with GA could provide better postoperative analgesia and better QoR than did GA alone in patients undergoing surgery for unilateral breast cancer.
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Acta Anaesthesiol Taiwan · Jun 2011
Increased oxidative stress and gut ischemia caused by prolonged pneumoperitoneum in patients undergoing robot-assisted laparoscopic radical prostatectomy.
To investigate changes in plasma oxidative stress markers associated with prolonged pneumoperitoneum during robot-assisted laparoscopic radical prostatectomy (RALP). ⋯ A prolonged pneumoperitoneum in RALP results in decreased splanchnic blood flow. Pneumoperitoneum itself produces oxidative stress, and ischemia-reperfusion model after deflation of pneumoperitoneum produces more oxidative stress.
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Functional hemodynamic parameters, such as stroke volume variation (SVV) and pulse pressure variation (PPV), are useful hemodynamic monitoring tools for the assessment of fluid responsiveness. These parameters are based on heart-lung interaction during positive mechanical pressure ventilation: Cyclic changes of intrathoracic pressure result in a reduced venous return and a decreased cardiac stroke volume after inspiration followed by a restoration of preload and stroke volume after expiration. Hemodynamic monitoring systems based on pulse wave analysis allow an automatic assessment of SVV and--at least for some of the devices--of PPV. ⋯ Arrhythmia and right heart failure, but also spontaneous breathing of a patient, or small tidal volumes may preclude reliable assessment. Based on these aspects, an ideal area of application of these parameters may be the use during perioperative hemodynamic optimization to improve patient outcome. However, only few studies on goal-directed therapy guided by these parameters have been published so far.
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Acta Anaesthesiol Taiwan · Jun 2011
Randomized Controlled TrialDo nondiabetic patients undergoing coronary artery bypass grafting surgery require intraoperative management of hyperglycemia?
To study the effect of blood glucose (BG) control with insulin in preventing hyperglycemia during and after coronary artery bypass grafting (CABG) surgery in nondiabetic patients. ⋯ Hyperglycemia (BG≥126 mg/dL) is common in nondiabetic patients undergoing CABG surgery. A modified insulin therapy to maintain BG level between 110 mg/dL and 126 mg/dL may be acceptable for avoiding hypoglycemia and keeping intraoperative BG levels in acceptable range in nondiabetics.