European journal of anaesthesiology
-
Comparative Study Clinical Trial
Sensory assessment of epidural block for Caesarean section: a systematic comparison of pinprick, cold and touch sensation.
Comparisons between the profile of regional blocks are difficult to make because different methods of testing are used among the studies. The aims of this prospective study were to describe the profile of epidural block by using a scoring system to evaluate the density of the block as assessed by the loss to pinprick, cold and touch sensation; to evaluate the extent of differential block and to determine whether there is any relationship between these three modalities of testing. ⋯ By scoring the density of the block on an ordinal scale, knowing the level of the block to pinprick allows one to predict the level of the block to touch and vice versa.
-
To investigate the effects of intra-aortic balloon pump therapy on parameters of global and regional oxygenation in patients undergoing cardiac surgery. ⋯ Intra-aortic balloon pump therapy improved global and regional splanchnic oxygenation in cardiac surgery patients with low-cardiac-output syndrome. Gastro-intestinal tonometry could provide additional information concerning tissue oxygenation. Patients with later intra-aortic balloon pump insertion needed more catecholamine therapy to achieve similar haemodynamic values.
-
Review
New approaches and old controversies to postoperative pain control following cardiac surgery.
To evaluate the effect of postoperative pain control in cardiac surgical patients on morbidity, mortality and other outcome measures. ⋯ Understanding perioperative pathophysiology and implementation of care regimes to reduce the stress of cardiac surgery, will continue to accelerate rehabilitation associated with decreased hospitalization and increased satisfaction and safety after discharge. Reorganization of the perioperative team (anaesthesiologists, surgeons, nurses and physical therapists) will be essential to achieve successful fast-track cardiac surgical programmes. Developments and improvements of multimodal interventions within the context of 'fast-track' cardiac surgery programmes represents the major challenge for the medical professionals working to achieve a 'pain and risk free' perioperative course.
-
Randomized Controlled Trial
Combination of hyperbaric lidocaine and ropivacaine in spinal anaesthesia for day surgery.
Motor function recovers rapidly but the extended duration of sensory block after spinal anaesthesia with hyperbaric ropivacaine may delay patients' ambulation after surgery. We tested whether compensating a reduction of the ropivacaine dose with a small dose of lidocaine would be adequate for surgery and shorten recovery from spinal anaesthesia. ⋯ It is concluded that spinal anaesthesia with hyperbaric lidocaine 20 mg+ropivacaine 5 mg and hyperbaric ropivacaine 10 mg was quite similar regarding frequency, onset, duration of T10 dermatome sensory block and recovery. The patients would have been ready for discharge after voluntary micturition, 4.2-4.5 h from the subarachnoid injection of local anaesthetics.
-
Clinical Trial
Prehospital intravenous line placement assessment in the French emergency system: a prospective study.
Out-of-hospital intravenous line placement is used daily. All available studies take place using paramedics, e.g. US-American emergency medical system. The aim of this study was to assess the intravenous line placement feasibility (time and success rate) in the French emergency medical system. ⋯ The out-of-hospital team was skilled at intravenous line placement (success rate=99.7%), and the time required to performed intravenous line access was short.