Anesthesiology
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Randomized Controlled Trial Comparative Study
A Randomized Control Trial of Bupivacaine and Fentanyl versus Fentanyl-only for Epidural Analgesia during the Second Stage of Labor.
Fentanyl-only epidural infusion shows no benefit over fentanyl/bupiv in respect to duration of labor, motor block, delivery, analgesia, or outcomes.
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Review Meta Analysis
Immediate Rescue Designs in Pediatric Analgesic Trials: A Systematic Review and Meta-analysis.
Opioid sparing is a feasible pragmatic endpoint for pediatric pain analgesic trials.
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Comparative Study Observational Study
Anaphylaxis Is More Common with Rocuronium and Succinylcholine than with Atracurium.
This retrospective, observational cohort study over 6 years from Auckland, New Zealand identified a 10 fold higher incidence of anaphylaxis for rocuronium than for atracurium.
Also of note, the rate of anaphylaxis to rocuronium was similar to that for suxamethonium.
Anaphylaxis incidence for the three muscle relaxants were approximately:
- Atracurium – 1 in 22,500
- Rocuronium – 1 in 2,500
- Suxamethonium – 1 in 2,000
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Multicapillary column ion-mobility spectrometry (MCC-IMS) may identify volatile components in exhaled gas. The authors therefore used MCC-IMS to evaluate exhaled gas in a rat model of sepsis, inflammation, and hemorrhagic shock. ⋯ Breath analysis of expired organic compounds differed significantly in septic, inflammation, and sham rats. MCC-IMS of exhaled breath deserves additional study as a noninvasive approach for distinguishing sepsis from inflammation.
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Randomized Controlled Trial
Transfusion Requirements in Surgical Oncology Patients: A Prospective, Randomized Controlled Trial.
The researchers found that in a cohort of 198 patients admitted to ICU after major abdominal cancer surgery, those subjected to a liberal blood transfusion threshold of < 9 g/dL experienced fewer major complications (NNT 6.2) than those subjected to a restrictive transfusion threshold (< 7 g/dL).
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