European journal of anaesthesiology
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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.
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The authors present a national survey determining the current practice of postoperative analgesia after major thoracic surgery in the United Kingdom. ⋯ The present survey demonstrates the increasing use of paravertebral block as an alternate regional anaesthetic technique to epidural analgesia after major thoracic surgery in the United Kingdom.
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Randomized Controlled Trial Comparative Study
Bispectral index monitoring during balanced xenon or sevoflurane anaesthesia in elderly patients.
In the elderly, monitoring depth of anaesthesia seems to be of particular importance. We evaluated the bispectral index (BIS) for monitoring depth of anaesthesia during clinically guided balanced xenon or sevoflurane anaesthesia in aged patients. ⋯ During xenon and sevoflurane anaesthesia in the elderly, BIS-values show sufficient concordance with clinical signs of anaesthetic depth. Since during clinically guided anaesthesia values were at the lower recommended limit, additional BIS monitoring may help reduce anaesthetic consumption and costs.
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Randomized Controlled Trial Comparative Study
Xenon anaesthesia produces better early postoperative cognitive recovery than sevoflurane anaesthesia.
Xenon anaesthesia may have the potential to reduce postoperative cognitive impairment after general anaesthesia. This randomized double-blind controlled trial was designed to compare the early postoperative cognitive recovery after xenon and sevoflurane anaesthesia. ⋯ Xenon anaesthesia was associated with faster emergence and with better early postoperative cognitive recovery than sevoflurane anaesthesia.