Anesthesia and analgesia
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Anesthesia and analgesia · Mar 2008
Clinical TrialDecision support increases guideline adherence for prescribing postoperative nausea and vomiting prophylaxis.
Guidelines for postoperative nausea and vomiting (PONV) prevention are implemented widely but their effectiveness may be limited by poor adherence. We hypothesized that the use of an electronic decision support (DS) system would significantly improve guideline adherence. ⋯ Electronic DS increases guidelines adherence for the prescription of PONV prophylaxis in high-risk PONV patients.
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Anesthesia and analgesia · Mar 2008
Clinical TrialThe effect of thoracic epidural bupivacaine and an intravenous adrenaline infusion on gastric tube blood flow during esophagectomy.
Gastric tube necrosis is a major cause of anastomotic leak after esophagectomy. A correlation has been shown between reduced flux at the anastomotic end of the gastric tube and anastomotic leaks. ⋯ The administration of a thoracic epidural bolus may decrease flux at the anastomotic end of the gastric tube.
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Anesthesia and analgesia · Mar 2008
Comparative StudyImproved clot formation by combined administration of activated factor VII (NovoSeven) and fibrinogen (Haemocomplettan P).
Recombinant activated factor VII (rFVIIa) is increasingly used for treating refractory bleeding after cardiac surgery. However, hemostasis also depends on coagulation factors, including fibrinogen, which stabilizes platelet plugs at sites of vascular injury. We compared the hemostatic effects of rFVIIa, fibrinogen, or their combination. ⋯ The onset of fibrin formation and thrombin generation were shortened after rFVIIa addition, but fibrin clot strength was only increased after fibrinogen supplementation. In vitro clot formation was most improved by using both rFVIIa and fibrinogen in whole blood after CPB.
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Anesthesia and analgesia · Mar 2008
Comparative StudyA comparison of preoperative anxiety in female patients with mothers of children undergoing surgery.
We compared anxiety in mothers of children undergoing ambulatory surgery with female patients undergoing surgery themselves. We found that mothers were as anxious as patients undergoing major abdominal surgery and more anxious than patients undergoing minor surgery. Predictors of maternal anxiety were child age and maternal monitoring coping.
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Anesthesia and analgesia · Mar 2008
Comparative StudyMeasurement of blood flow index during antegrade selective cerebral perfusion with near-infrared spectroscopy in newborn piglets.
Neonates with complex congenital heart defects have traditionally undergone surgery during deep hypothermic cardiac arrest (HCA). Selective cerebral perfusion (SCP) is thought to minimize ischemic brain injury by providing adequate cerebral blood flow. We investigated SCP with different flow rates compared with HCA with respect to cerebral perfusion and tissue oxygenation as assessed by near-infrared spectroscopy. ⋯ Both BFI and FV(mean) suggested increased cerebral perfusion in the SCP 50 group compared with the HCA and SCP 25 groups. TOI was significantly higher in both the SCP 25 and SCP 50 groups compared with HCA. SCP at 25 mL x kg(-1) x min(-1) may be most appropriate for cerebral protection.