European journal of anaesthesiology
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Neuraxial anaesthesia has been shown to produce a sedative and anaesthetic-sparing effect. The purpose of the present study was to determine the effects of acute spinal cord injury on sevoflurane requirement and stress hormone responses during spinal surgery at the level of the injury. ⋯ Spinal cord injury neither alters the anaesthetic requirement regardless of the level of injury during spinal surgery at the level of the injury, nor enhances arginine vasopressin release. However, it blunts catecholamine responses in quadriplegics.
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Randomized Controlled Trial Comparative Study
Dexamethasone for postoperative nausea and vomiting prophylaxis: effect on glycaemia in obese patients with impaired glucose tolerance.
Dexamethasone given to prevent postoperative nausea and vomiting may produce significant hyperglycaemia in the perioperative period. The effect of dexamethasone on patients with impaired glucose tolerance is unknown. ⋯ Dexamethasone, 8 mg, intravenously administered at the beginning of laparoscopic bariatric surgery in patients with impaired glucose tolerance is associated with significantly increased postoperative blood glucose concentrations.
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Randomized Controlled Trial Comparative Study
The effect of scalp block and local infiltration on the haemodynamic and stress response to skull-pin placement for craniotomy.
The insertion of skull pins into the periosteum induces not only a haemodynamic response but also an increase in stress hormones. We compared the effects of scalp-nerve block, infiltration anaesthesia, and routine anaesthesia during skull-pin insertion on haemodynamic and stress responses to craniotomy. ⋯ We conclude that scalp block using 0.5% bupivacaine blunts the haemodynamic and stress responses to head pinning better than routine anaesthesia or scalp infiltration with bupivacaine and should be considered in conjunction with general anaesthesia for craniotomy.
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Randomized Controlled Trial
Effects of changes in blood pressure and airway pressures on parameters of fluid responsiveness.
Systolic pressure variation (SPV) and stroke volume variation (SVV) are clinical indicators of fluid responsiveness. However, several factors may influence these parameters and thereby limit their usefulness. In this clinical study, we analysed SPV and SVV in comparison with static preload parameters during an increase in arterial blood pressure (BP) and airway pressure. ⋯ In cardiac surgical patients with preserved cardiac index, SVV, but not SPV, decreased during an acute increase in BP, whereas both parameters, in contrast to cardiac filling pressures, significantly increased with higher tidal volume.