European journal of anaesthesiology
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Randomized Controlled Trial
Ropivacaine vs. levobupivacaine combined with sufentanil for epidural analgesia after lung surgery.
There are no clinical studies that compare epidural infusion of ropivacaine and levobupivacaine in patients undergoing lung surgery. The aim of this prospective, randomized double-blind study was to evaluate the efficacy and safety of two commercially available solutions of ropivacaine (0.2% w/v) and levobupivacaine (0.125% w/v) when administered by continuous epidural infusion together with sufentanil in patients undergoing lung surgery. ⋯ Equivalent volumes of ropivacaine (0.2% w/v) and levobupivacaine (0.125% w/v) provided similar static and dynamic analgesia with similar incidence of minor side-effects after thoracotomy.
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Randomized Controlled Trial Comparative Study
Dexmedetomidine causes prolonged recovery when compared with midazolam/fentanyl combination in outpatient shock wave lithotripsy.
Analgesia and sedation are usually required during extracorporeal shock wave lithotripsy. In the present study, the recovery time and effectiveness of sedation and analgesia of dexmedetomidine was compared with a midazolam/fentanyl combination in outpatient extracorporeal shock wave lithotripsy. ⋯ Dexmedetomidine was associated with a longer recovery time than a midazolam/fentanyl combination when used for sedation and analgesia during outpatient extracorporeal shock wave lithotripsy in this study. The incidence of rescue sedative and analgesic need was also significantly higher when dexmedetomidine was used.
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Randomized Controlled Trial Comparative Study
A comparison of caudal bupivacaine and ketamine with penile block for paediatric circumcision.
To establish whether caudal with ketamine or penile block provide superior postoperative analgesia for paediatric circumcision. ⋯ Caudal bupivacaine with ketamine and penile block both provide effective postoperative analgesia for circumcision when given with non-steroidal anti-inflammatory drugs. This study shows that caudal bupivacaine with ketamine provides a longer duration of analgesia than penile block, but also causes delay in walking.
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We investigated cerebrospinal fluid characteristics in patients with and without diabetes mellitus and the influences that changes in these characteristics have on sensory and motor block when spinal anaesthesia is performed. ⋯ This study shows that diabetes mellitus has an influence on sensory and motor block after the administration of spinal isobaric bupivacaine.
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With the increasing demand for one-lung ventilation in both thoracic surgery and other procedures, identifying the correct placement becomes increasingly important. Currently, endobronchial intubation is suspected based on a combination of auscultation and physiological findings. We investigated the ability of the visual display of airflow-induced vibrations to detect single-lung ventilation with a double-lumen endotracheal tube. ⋯ During single-lung ventilation, vibration response imaging clearly showed increased vibration in the lung that is being ventilated. Distribution of residual vibration differed in the non-ventilated lung in a manner that suggests transmission of vibrations across the mediastinum from the ventilated lung. The lung image and video obtained from vibration response imaging may provide useful and immediate information to help one-lung ventilation assessment.