European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Total intravenous anaesthesia using propofol, gamma-hydroxybutyrate or midazolam in combination with sufentanil for patients undergoing coronary artery bypass surgery.
Total intravenous anaesthesia (TIVA) using propofol, gamma-hydroxybutyrate (GHB) or midazolam in combination with sufentanil was investigated in 45 patients undergoing coronary artery bypass grafting (CABG). Anaesthesia was induced with sufentanil, etomidate and pancuronium. After endotracheal intubation, anaesthesia was continued with sufentanil (2 micrograms kg-1 h-1) for all patients. ⋯ No electrocardiographical signs of ischaemia were observed in any patient. In the case of propofol and midazolam, gamma-hydroxybutyrate showed adequate haemodynamic stability especially after induction of anaesthesia and may also be a suitable agent for total intravenous anaesthesia in patients with coronary artery disease. However, during sternotomy, supplementary administration of opioids was required.
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Comparative Study Clinical Trial Controlled Clinical Trial
Assessment of accelerography with the TOF-GUARD: a comparison with electromyography.
The TOF-GUARD is a new device for monitoring the neuromuscular function using acceleration measurement. It is quick and easy to apply and does not require a rigid support for the arm. ⋯ The levels at intubation as well as at full recovery of the patients can be assessed equally by the two monitors. Thus, the TOF-GUARD is a reliable clinical monitor in daily anaesthesia practice.
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Clinical Trial
Peri-operative thoracic epidural analgesia for thoracotomy.
In a prospective study, experiences with peri-operative thoracic epidural analgesia (TEA) for thoracic surgery were documented. Two hundred and seven patients scheduled for elective thoracotomy were investigated. All patients received thoracic epidural catheters 2 h pre-operatively. ⋯ Ninety-five percent of the patients were extubated immediately after surgery. 70.5% of all the patients had excellent post-operative analgesia (VAS pain scoring 0-2) on the day of surgery, 78% the day after surgery and 91% on the second day after surgery. Additionally early post-operative mobilization could be started in 63% of all patients. No neurological sequelae caused by thoracic epidural catheterization was seen in the early post-operative period.
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Case Reports
Pneumopericardium associated with high-frequency jet ventilation during laser surgery of the hypopharynx in a child.
A case of pneumopericardium, without concomitant pneumothorax, resulting from high frequency jet ventilation during laser surgery of the hypopharynx is described. The patient, a four-year-old boy, suffered cardiac arrest as a consequence of the incident. The pneumopericardium was likely to have been caused by obstruction to the expiratory flow during surgery. Other possible explanations for the incident are discussed.