European journal of anaesthesiology
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Randomized Controlled Trial
Reduction of pain on injection of propofol: combination of pretreatment of remifentanil and premixture of lidocaine with propofol.
There is a high incidence of pain following intravenous injection of propofol, and many studies have been conducted to find a way of reducing this. The administration of lidocaine and, recently, remifentanil has also been used for this purpose, but it is only partially effective. Thus, the purpose of this study was to investigate the analgesic effect of a combination of pretreatment with remifentanil and premixture of lidocaine with propofol and to compare either treatment alone during propofol injection in dorsal hand-veins. ⋯ The combination of pretreatment of remifentanil and premixture of lidocaine with propofol was more effective in reducing the incidence of pain on injection of propofol than either treatment alone.
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In most studies of cardiac output changes after spinal anaesthesia, the time-resolution is limited. The aim of this study was to demonstrate cardiac output changes with high time-resolution during onset of spinal anaesthesia in elderly patients. ⋯ Using this high time-resolution method, we detected biphasic changes in cardiac output during onset of spinal anaesthesia. Initially, cardiac output increased. Subsequently, it was significantly reduced from baseline, although this decrease was of minor clinical importance.
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The importance of monitoring the breathing pattern during sedation of children undergoing magnetic resonance scans is indicated in guidelines, but no appropriate magnetic resonance-compatible devices are available. We report preliminary findings from a technique referred to as remote pressure sensor respiratory plethysmography. ⋯ Breathing pattern monitoring is feasible through pneumatic devices, which are well tolerated. The resulting correlation with changes in tidal volume can be better when compared to visual inspection. Proportion of inspiratory time over cycle time and sigh rate convey information related to the state of the sedated patient. These results are not specific to the technology employed, and large-scale studies on the clinical usefulness of breathing pattern monitoring are motivated.
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Randomized Controlled Trial Comparative Study
Bispectral index and electroencephalographic entropy in patients undergoing aortocoronary bypass grafting.
This study was conducted to compare bispectral index, state entropy and response entropy in patients undergoing coronary artery bypass grafting. ⋯ In patients undergoing coronary artery bypass grafting, no relationship was found between bispectral index levels and state entropy and response entropy at two different stages of a sufentanil-midazolam anaesthesia. A bispectral index level of 45-55 reduced anaesthetic medications used and the need for inotropic support.