European journal of anaesthesiology
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Randomized Controlled Trial Multicenter Study Comparative Study
Reversal of rocuronium-induced neuromuscular blockade with sugammadex compared with neostigmine during sevoflurane anaesthesia: results of a randomised, controlled trial.
Sugammadex, a modified gamma-cyclodextrin, is a selective relaxant-binding agent designed to reverse the effects of the steroidal neuromuscular blocking agents rocuronium or vecuronium. This study compared the efficacy of sugammadex and neostigmine for reversal of neuromuscular blockade induced by rocuronium for facilitating elective surgery. ⋯ Sugammadex achieved significantly faster recovery of neuromuscular function after rocuronium to a TOF ratio of 0.9 compared with neostigmine (Clinicaltrials.gov identifier: NCT00451217).
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Randomized Controlled Trial Multicenter Study Comparative Study
A randomized simultaneous comparison of acceleromyography with a peripheral nerve stimulator for assessing reversal of rocuronium-induced neuromuscular blockade with sugammadex.
We investigated the relationship between acceleromyography and a peripheral nerve stimulator for measuring reversal in patients administered sugammadex following rocuronium. ⋯ T4 is detected at similar times when measured by a peripheral nerve stimulator or acceleromyography following sugammadex 4.0 mg kg administration 15 min after rocuronium. The mean interval between T4 reappearance (peripheral nerve stimulator) and recovery to a train-of-four ratio of at least 0.9 (acceleromyography) was 0.8 min. These findings provide guidance for evaluating the reversal effect of sugammadex in clinical situations.
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The study was conducted to evaluate the correlation of central venous-arterial and mixed venous-arterial pCO(2) gradient with cardiac output in patients being operated in the sitting position. ⋯ It seems that venous-arterial pCO(2) values obtained from mixed and central venous circulations can be reliably interchanged in estimating CI in patients undergoing neurosurgical procedures in the sitting position. Thus, central venous-arterial pCO(2) gradient could serve as a useful and simple method for estimating cardiac performance, in which further invasive monitoring is not strongly indicated.
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Although clinical guidelines recommend systematic evaluation of pain in ICU patients, we know little about the effects from such systematic pain evaluation. This study aims to quantify the effect of a pain management programme in the ICU. ⋯ The intervention programme successfully reduced the occurrence of unacceptable pain. Further improvement of pain management should focus on the prevention of pain.