European journal of anaesthesiology
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Elevated blood levels of lidocaine and ropivacaine have been described after transversus abdominis plane (TAP) block. ⋯ TAP blocks with bilateral injections of 20 ml ropivacaine 0.5% w/v gave rise to potentially toxic peak blood concentrations of total ropivacaine in one-third of the patients.
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Randomized Controlled Trial Multicenter Study Comparative Study
Effects of four different positive airway pressures on right internal jugular vein catheterisation.
The right internal jugular vein (RIJV) is often used for central venous catheterisation in patients undergoing major surgery. The efficacy of this route correlates with the diameter of the vein which can be influenced by airway pressure. ⋯ A PAP of 20 cmH2O seems most suitable for successful RIJV catheterisation in mechanically ventilated patients. It is associated with an increase in cross-sectional RIJV area and CVP, which facilitate cannulation, and results in fewer puncture-related complications. However, meticulous haemodynamic monitoring is needed to avoid hypotension and bradycardia.
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Postoperative cognitive dysfunction has been reported in young, middle-aged and elderly patients with greater incidence with increasing age. Neurocognitive deficits are associated with anaesthetic exposure in aged rodents but in younger adult animals the findings are inconsistent and in middle-aged animals they are unknown. We aimed to compare the effects of moderate duration isoflurane anaesthesia in 100% oxygen on Morris water maze performance in young adult and middle-aged rats. We hypothesised that isoflurane would have greater effects on learning and memory in middle-aged compared with young rats. ⋯ Isoflurane exposure impaired retention memory for platform location 1 week after exposure in young adult rats and resulted in a delayed although weak impairment at 4 weeks in middle-aged rats. The great variation in reported effects of isoflurane suggests a complex effect of this agent on memory which warrants further investigation.
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Letter Case Reports
ECG changes during in-situ hypothermic liver resections.