European journal of anaesthesiology
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In this review, we shall consider the oral and intravenous fluid management of pregnant women during labour and operative delivery in the context of neuroaxial blockade. We shall also discuss the use of blood transfusion in the peripartum period, especially during postpartum haemorrhage. Current management of military casualties and major civilian trauma challenges traditional practices of blood product administration in massive haemorrhage and may radically modify transfusion practices during obstetric haemorrhage. Articles for inclusion were selected from medical databases, including MEDLINE and the Cochrane Library, and additional references were obtained from available relevant publications.
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Propofol sedation by non-anaesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. ⋯ This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline. The guideline is published simultaneously in the Journals Endoscopy and European Journal of Anaesthesiology.
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childhood obesity is a risk factor for many perioperative complications. Hypotension is a well described complication of general anaesthesia in both adults and children. This observational study compared the incidence of preincision hypotension (PIH) between children with high BMI and lean controls. ⋯ these results imply that children with high BMI have a higher incidence of hypotension than their lean peers following induction of anaesthesia for noncardiac procedures.
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Randomized Controlled Trial Comparative Study
Dexmedetomidine versus fentanyl as adjuvant to propofol: comparative study in children undergoing extracorporeal shock wave lithotripsy.
the present study was designed to compare the efficacy, tolerability and safety of dexmedetomidine and fentanyl when combined with propofol during extracorporeal shock wave lithotripsy in children. ⋯ both propofol/fentanyl and propofol/dexmedetomidine combinations at mentioned dose regimen were effective and well tolerated for children undergoing extracorporeal shock wave lithotripsy. However, propofol/dexmedetomidine combination was accompanied with less propofol consumption, prolonged analgesia and lower incidence of intraprocedural and postprocedural complications.
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despite the introduction of newer antiemetics in the prevention of postoperative nausea and vomiting (PONV), perphenazine is recommended in current guidelines, as the concept of multimodal management of PONV in high-risk patients requires more than two drugs to be combined. The aim of this quantitative systematic review was to assess the efficacy and safety of perphenazine in the prophylaxis of PONV in adults and children. ⋯ there is evidence that perphenazine is effective in the prevention of PONV in children and adults without serious adverse effects compared with placebo.