European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Effect of dexmedetomidine combined with sufentanil for post-caesarean section intravenous analgesia: A randomised, placebo-controlled study.
Few studies have investigated the use of dexmedetomidine in obstetric anaesthesia. ⋯ The combination of sufentanil and dexmedetomidine for PCA after caesarean section can reduce sufentanil consumption and improve parturients' satisfaction compared with sufentanil PCA alone.
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Randomized Controlled Trial Comparative Study
Intravenous alanyl-L-glutamine balances glucose-insulin homeostasis and facilitates recovery in patients undergoing colonic resection: A prospective, randomised controlled trial.
Glucose and insulin homeostasis are altered in patients undergoing gastro-intestinal tumour resection and affect the postsurgical outcomes. ⋯ Intravenous supplementation with glutamine balances glucose-insulin homeostasis and facilitates recovery in patients undergoing colon cancer resection.
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Randomized Controlled Trial
Epidural neostigmine and clonidine improves the quality of combined spinal epidural analgesia in labour: A randomised, double-blind controlled trial.
In labour analgesia, the combination of epidural clonidine and neostigmine as adjuvants to local anaesthetics and opioids is under investigation to provide a longer duration of initial spinal analgesia with local anaesthetics and/or opioids. ⋯ The administration of epidural clonidine and neostigmine as adjuvants, following spinal injection of local anaesthetic, improves the quality of analgesia with less ropivacaine consumption, higher patient satisfaction 1 h after administration and a decrease in breakthrough pain compared to standard combined spinal and epidural analgesia and patient-controlled epidural analgesia with ropivacaine and sufentanil.
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Randomized Controlled Trial
The influence of a prophylactic dose of dexamethasone for postoperative nausea and vomiting on plasma interleukin concentrations after laparoscopic cholecystectomy: A prospective randomised trial.
Little is known about the effects of small doses of dexamethasone used for the prophylaxis of postoperative nausea and vomiting on the innate host response. ⋯ Prophylactic dexamethasone given before laparoscopic cholecystectomy produced a significant decrease in concentrations of interleukins 6 and 8. Further studies are needed to investigate the clinical implications of these findings.
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Preeclampsia continues to be a leading cause of maternal and foetal mortality and morbidity worldwide. It is defined as hypertension and proteinuria after 20 weeks' gestation, which resolves after delivery. It is complicated by intracerebral haemorrhage, pulmonary oedema and respiratory and hepatic failure, which form the commonest causes of death. ⋯ A fluid restriction policy should be used to prevent iatrogenic pulmonary oedema. Effective anaesthetic management relies on neuraxial techniques. Epidural, combined spinal-epidural and single-shot spinal anaesthetic techniques are all perfectly acceptable and should be actively promoted to the mother unless contraindications such as thrombocytopaenia exist.