European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
The influence of fentanyl vs. s-ketamine on intubating conditions during induction of anaesthesia with etomidate and rocuronium.
In the present study, we investigated the combination of etomidate and s-ketamine with regard to its suitability for modified rapid-sequence induction using rocuronium for muscle relaxation. ⋯ The combination of etomidate and s-ketamine for anaesthesia induction produces mostly excellent intubating conditions after 60 s using only 0.6 mg kg-1 of rocuronium. This combination of drugs may be a useful alternative, if succinylcholine needs to be avoided, for modified rapid-sequence induction.
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Randomized Controlled Trial Clinical Trial
The effect of lidocaine on neutrophil respiratory burst during induction of general anaesthesia and tracheal intubation.
Respiratory burst is an essential component of the neutrophil's biocidal function. In vitro, sodium thiopental, isoflurane and lidocaine each inhibit neutrophil respiratory burst. The objectives of this study were (a) to determine the effect of a standard clinical induction/tracheal intubation sequence on neutrophil respiratory burst and (b) to determine the effect of intravenous lidocaine administration during induction of anaesthesia on neutrophil respiratory burst. ⋯ Induction of anaesthesia and tracheal intubation using thiopentone and isoflurane, inhibit neutrophil respiratory burst. This effect may be diminished by the administration of lidocaine.
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Randomized Controlled Trial Clinical Trial
Low-flow anaesthesia with desflurane: kinetics during clinical procedures.
Low-flow anaesthesia is economical and less polluting. The purpose of this study was to determine the inspired and end-tidal desflurane concentrations during anaesthesia with a vaporizer setting maintained at 5%, during low-flow anaesthesia after 120 min with fresh gas inflows of 1.0 and 2.0 L min-1. ⋯ There is a significant difference between the inspired and end-tidal concentrations of desflurane when fresh gas inflows were 1.0 and 2.0 L min-1, but not for the ratio of inspired/end-tidal.
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As is often the case in medicine, the risk to benefit ratio of blood transfusion requires careful examination. The decision to transfuse a patient cannot be based only on the haemoglobin or the haematocrit concentration. ⋯ In the absence of a universal transfusion trigger, decision to transfuse a patient with an haemoglobin concentration between 7.0 and 10.0 g dL-1 depends primarily on clinical judgement. With the exception of emergency situations, blood transfusion will be realized on a unit-by-unit basis, and the efficacy of treatment should be evaluated after each transfused unit.