European journal of anaesthesiology
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Sedation is frequently used during ophthalmic regional anaesthesia. There is no 'ideal' drug for sedation or analgesia. Various drugs either alone or in combination have been used with different methods of administration. This review includes the roles of sedation, the pharmacology of drugs and the safety of sedation in patients undergoing ophthalmic surgery.
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Randomized Controlled Trial Comparative Study
Individual titration of propofol plasma target improves anaesthetic stability in patients undergoing major abdominal surgery: a comparison with manually controlled infusion.
The impact of anaesthesia using target-controlled infusion with propofol on intraoperative stability, recovery and cost compared to manually controlled infusion has been evaluated with inconsistent results. We studied a new device that allows more individual titration of propofol target-controlled infusion by using the effect-site concentration at the loss of eyelash reflex to predict the maintenance infusion rate (FM-TCI). ⋯ FM-TCI helps to provide more stable anaesthesia conditions requiring less-frequent adjustments of the propofol infusion compared to manually controlled infusion in patients undergoing major abdominal surgery.
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Failed intubation is an important cause of anaesthetic-related maternal mortality. The purpose of this study was to determine the ability to predict difficult visualization of the larynx from the following preoperative airway predictive indices, in isolation and combination: modified Mallampati test, the ratio of height to thyromental distance and the Upper-Lip-Bite test. ⋯ The ratio of height to thyromental distance may prove a useful screening test for predicting difficult laryngoscopy in obstetric population.
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Randomized Controlled Trial
Lornoxicam attenuates the haemodynamic responses to laryngoscopy and tracheal intubation in the elderly.
Lornoxicam is a novel non-steroidal anti-inflammatory drug with marked analgesic property. It has been shown to have analgesic potency similar to morphine and meperidine. Laryngoscopy and tracheal intubation provoke major haemodynamic responses. Minimizing perioperative adverse events in elderly patients is of utmost importance. The aim of this study was to demonstrate the effect of preoperative administration of Lornoxicam on haemodynamic changes during laryngoscopy and tracheal intubation in the elderly. ⋯ Preoperative administration of Lornoxicam attenuates the haemodynamic response to laryngoscopy and tracheal intubation in the elderly.
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Randomized Controlled Trial Comparative Study
Bronchial mucus transport velocity in patients receiving desflurane and fentanyl vs. sevoflurane and fentanyl.
Sevoflurane has been shown to distinctly reduce bronchial mucus transport velocity, an essential determinant of mucociliary clearance and pulmonary complications. However, sevoflurane is regarded as one of the least irritant volatile anaesthetics, especially when compared with desflurane. Hence, the aim of this double-blind, randomized, controlled trial was to assess differences in bronchial mucus transport velocity between sevoflurane and desflurane. ⋯ Desflurane is commonly regarded as more irritant to the airway, but as far as bronchial mucus transport velocity is concerned, the choice between sevoflurane and desflurane does not seem to matter.