European journal of anaesthesiology
-
Retraction Of Publication
Pharmacokinetics and pharmacodynamics of the new propofol prodrug GPI 15715 in rats: Retraction.
-
Randomized Controlled Trial Comparative Study
Volatile induction/maintenance of anaesthesia with sevoflurane increases jugular venous oxygen saturation and lumbar cerebrospinal fluid pressure in patients undergoing craniotomy.
Sevoflurane is a widely used volatile agent in neuroanaesthesia, and its nonirritant properties on the respiratory tract make sevoflurane suitable for volatile induction/maintenance of anaesthesia (VIMA). In the current trial, we investigate the effects of sevoflurane VIMA on lumbar cerebral fluid pressure (LCSFP) and jugular venous oxygen partial pressure in patients undergoing craniotomy for supratentorial intracranial surgery under bispectral index monitoring, determine jugular bulb venous oxygen saturation (SjvO2) and calculate cerebral perfusion pressure (CPP), arteriojugular venous oxygen content difference and cerebral oxygen extraction rate (COER) at different time points during the operation. Moreover, we compare these with total intravenous anaesthesia (TIVA) in patients receiving remifentanil and propofol continuous infusion. ⋯ Sevoflurane VIMA increases SjvO2, lumbar CSF pressure and CPP, and decreases COER, which suggested that VIMA could be a better choice for patients with the risk of cerebral hypoperfusion or insufficient oxygen delivery. Propofol-based TIVA is associated with decreased SjvO2, LCSFP and CPP, and increased COER, and it might be suitable for patients with increased intracranial pressure.
-
Pulmonary hypertensive patients going for surgery are at significant risk of perioperative morbidity and mortality. They pose a clinically challenging situation for the anaesthetist and strategies to minimize the effects on these patients are discussed. Recent advances have allowed a better understanding of the pathophysiological mechanisms and development of new therapies. ⋯ An update on the recent advances in medical therapy with calcium channel blockers, prostacyclin analogues, endothelin receptor antagonists and phosphodiesterase-5 inhibitors is provided and relevant anaesthetic concerns highlighted. Key strategies for intraoperative management are presented and we review the options and novel strategies for managing an acute episode of decompensated pulmonary hypertension intraoperatively. Promising new therapies being explored include intraoperative delivery of inhaled milrinone and inhaled prostacyclin analogues.
-
Randomized Controlled Trial
Effect of preoperative gabapentin on postoperative pain and tramadol consumption after minilap open cholecystectomy: a randomized double-blind, placebo-controlled trial.
To evaluate the efficacy of a single preoperative dose of 600 mg of gabapentin for reducing postoperative pain and tramadol consumption after minilap open cholecystectomy. ⋯ Preoperative administration of 600 mg of gabapentin resulted in significant reduction in postoperative verbal analogue pain scores at rest and at movement as well as tramadol consumption compared with placebo on first postoperative day. Lower incidence of nausea and vomiting was an additional advantage. Sedation was the commonest side effect.