European journal of anaesthesiology
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Randomized Controlled Trial
Low-dose neostigmine to antagonise shallow atracurium neuromuscular block during inhalational anaesthesia: A prospective randomised controlled trial.
Even shallow residual neuromuscular block [i.e. train-of-four (TOF) ratio around 0.6] is harmful. It can be effectively antagonised by small doses of neostigmine, but reports are limited to intravenous anaesthesia. Inhalational anaesthesia may enhance neuromuscular block and delay recovery. It is not known whether low doses of neostigmine are still effective in the context of inhalational anaesthesia. ⋯ Under desflurane anaesthesia, neostigmine 10 µg kg(-1) is effective in antagonising shallow atracurium block. Compared to no neostigmine, the time to a TOF ratio more than 0.9 was shortened and neuromuscular recovery at 5 and 10 min was more advanced.
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Randomized Controlled Trial
Effects of magnesium sulphate on the pharmacodynamics of rocuronium in patients aged 60 years and older: A randomised controlled study.
There is little information on the interaction between magnesium sulphate (MgSO4) and rocuronium in elderly patients. With a growing number of older patients who need surgical procedures, it is increasingly important to study this age group. ⋯ In oncology patients of 60 or more years of age, preadministration of MgSO4, with the doses used in this study, significantly reduced the onset time of NMB induced by rocuronium.
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Propofol target-controlled infusion (TCI) in effect site mode has become popular since it became commercially available. ⋯ Pharmacokinetic analysis suggests that the performance of the Marsh model in effect site mode is poor in this broad patient population. The greatest bias demonstrated occurred in the early maintenance phase of anaesthesia. Of the covariates analysed, obesity contributed most significantly to an increased bias. Despite overall poor performance of the Marsh model, attending anaesthesiologists modified targeted propofol concentrations only 0.3 times per hour on average, using remifentanil dose modification nine times more frequently, with good surgical conditions in all patients.
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Comparative Study
Effects of isoflurane-induced anaesthesia on cognitive performance in a mouse model of Alzheimer's disease: a randomised trial in transgenic APP23 mice.
Results from in-vitro experiments suggest that inhalational anaesthetics may have a detrimental effect on the course and incidence of Alzheimer's disease. However, case-control studies in humans show no negative impact of anaesthetics on the course of Alzheimer's disease. ⋯ Isoflurane may have protective, rather than detrimental, effects on cognition in Alzheimer's disease.