European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Comparison of the effects of low-flow and high-flow inhalational anaesthesia with nitrous oxide and desflurane on mucociliary activity and pulmonary function tests.
The aim of this study was to investigate the effects of inhalational anaesthesia using low and high gas flow rates of nitrous oxide and desflurane on mucociliary clearance and pulmonary function. ⋯ Respiratory function and mucociliary clearance are better preserved in a low-flow anaesthesia technique than in high-flow anaesthesia with nitrous oxide and desflurane. Therefore, a low-flow anaesthesia technique with nitrous oxide and desflurane may provide an important clinical advantage because it provides appropriately heated and humidified gases to the tracheobronchial tree.
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Fentanyl is metabolised by cytochrome P450 (CYP) 3A4 and CYP3A5. Our previous work demonstrated that the CYP3A4*1G polymorphism significantly affects the post-operative fentanyl analgesic effect in Chinese women undergoing gynaecological surgery. However, whether CYP3A5*3, a frequent single nucleotide polymorphism of CYP3A5 in Chinese people, affects the post-operative analgesic effect of fentanyl is unclear. In this study, we assessed the influence of the CYP3A5*3 polymorphism and the interaction of the CYP3A5*3 and CYP3A4*1G polymorphisms on post-operative fentanyl analgesia in Chinese women undergoing gynaecological surgery. ⋯ CYP3A5*3 is not the main genetic factor contributing to interindividual variation in the post-operative analgesic effect of fentanyl in Chinese women undergoing gynaecological surgery; an interaction between CYP3A5*3 and CYP3A4*1G polymorphisms can significantly influence the post-operative effect.
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Randomized Controlled Trial
A preemptive alveolar recruitment strategy before one-lung ventilation improves arterial oxygenation in patients undergoing thoracic surgery: a prospective randomised study.
Arterial hypoxaemia remains a problem during one-lung ventilation (OLV). We determined whether a preemptive alveolar recruitment strategy (ARS) before OLV improves arterial oxygenation during OLV in patients undergoing thoracic surgery. ⋯ Preemptive ARS before OLV is effective in improving arterial oxygenation during the entire period of OLV.
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Comparative Study Clinical Trial
Effect of sex and pregnancy on the potency of intrathecal bupivacaine: determination of ED₅₀ for motor block with the up-down sequential allocation method.
The up-down sequential allocation model has been adapted to estimate the relative potency ratios for analgesia and motor block of the most commonly used epidural and intrathecal local anaesthetics. The aim of this study was to establish the median effective doses (ED50) for motor block with intrathecal bupivacaine and to estimate the ED50 ratios of these in male, female and pregnant patients. ⋯ We have demonstrated a hierarchy of potencies for motor block with intrathecal bupivacaine for men, women and pregnant women suggesting possible relevant differences owing to the effects of both sex and pregnancy.