European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Comparative evaluation of propofol 350 and 200 mg for induction of anaesthesia in morbidly obese patients: a randomized double-blind pilot study.
The aim of this pilot study was to evaluate efficacy and safety of propofol 350 versus 200 mg for induction of anaesthesia in morbidly obese patients undergoing bariatric surgery. ⋯ Although propofol 200 mg proved to be an inadequate induction dose for morbidly obese patients, the 350 mg induction dose deserves further study, provided the maintenance dose is not started within 5 min, thereby preventing temporary cardiovascular instability.
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Randomized Controlled Trial Comparative Study
Study of the systemic and pulmonary oxidative stress status during exposure to propofol and sevoflurane anaesthesia during thoracic surgery.
General anaesthesia during mechanical ventilation can induce variable systemic and pulmonary immune effects that may affect postoperative outcome. The aim of the present study was to evaluate evidence of oxidative stress in the blood and bronchoalveolar lavage (BAL) fluid of patients exposed to propofol or sevoflurane anaesthesia during thoracic surgery. ⋯ Sevoflurane seemed to induce a local and systemic oxidative stress, whereas propofol is more likely to have antioxidant properties. Sevoflurane appears to cause a greater intrapulmonary proinflammatory response than propofol during thoracic surgery.
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Accurate assessment of a patient's volume status is an important goal for an anaesthetist. However, most variables assessing fluid responsiveness are either invasive or technically challenging. This study was designed to compare the accuracy of arterial pressure-based stroke volume variation (SVV) and variations in the pulse oximeter plethysmographic waveform amplitude as evaluated with the noninvasive calculated pleth variability index (PVI) with central venous pressure to predict the response of stroke volume index (SVI) to volume replacement in patients undergoing major surgery. ⋯ Although arterial pressure-derived SVV revealed the best correlation to volume-induced changes in SVI, the results of our study suggest that both variables, SVV and PVI, can serve as valid indicators of fluid responsiveness in mechanically ventilated patients undergoing major surgery.
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Randomized Controlled Trial
An opioid-free anaesthetic using nerve blocks enhances rapid recovery after minor hand surgery in children.
The aim of this prospective randomized study was to evaluate the quality of analgesia, postoperative comfort and subsequent duration of hospitalization after distal hand surgery and peripheral nerve block at the wrist for paediatric outpatients. ⋯ The present study demonstrates for the first time that, after distal hand surgery in children, peripheral nerve block improves pain management, opioid analgesia-induced side effects and provides a shorter postoperative recovery time than systemic analgesia with opioids.
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The present study investigated whether positioning of the heart during off-pump coronary artery bypass grafting leads to changes in regional cerebral oxygen saturation measured by near infrared spectroscopy. ⋯ Positioning of the heart during off-pump coronary artery bypass grafting leads to a decrease in regional cerebral oxygen saturation. This decrease is associated with changes in cardiac output, haemoglobin concentration, arterial CO2 partial pressure, and central venous pressure.