European journal of anaesthesiology
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Randomized Controlled Trial Observational Study
Intraoperative monitoring of analgesia using nociceptive reflexes correlates with delayed extubation and immediate postoperative pain: A prospective observational study.
Immediate postoperative pain could be prevented by the administration of long-lasting analgesics before the end of the anaesthesia. However, to prevent over or underdosing of analgesics under anaesthesia, tools are required to estimate the analgesia-nociception balance. ⋯ The investigated nociceptive reflexes reflected the analgesia-nociception balance under general anaesthesia. The preoperative reflexes provide additional information about individual subjective pain sensitivity.
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Clinical Trial Observational Study
Significance of new Q waves and their location in postoperative ECGs after elective on-pump cardiac surgery: An observational cohort study.
The clinical significance of new pathological Q waves after on-pump cardiac surgery is uncertain. ⋯ The current analysis suggests that for patients undergoing elective on-pump cardiac surgery, only new pathological Q waves in V1 to V5 (anterior) in the 7th postoperative day ECG are associated with 12-month, all-cause mortality and/or MACE.
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Clinical Trial Observational Study
Evaluation of augmented pulse pressure variation using the Valsalva manoeuvre as a predictor of fluid responsiveness under open-chest conditions: A prospective observational study.
Pulse pressure variation (PPV) is a well known dynamic preload indicator of fluid responsiveness. However, its usefulness in open-chest conditions remains controversial. ⋯ Augmented PPV using a Valsalva manoeuvre can be used as a clinically reliable predictor of fluid responsiveness under open-chest condition.
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Nonopioid analgesic drugs may interfere with platelet inhibition by aspirin. Recent in vitro and clinical studies in patients with cardiovascular disease have suggested that this pharmacodynamic interaction may also occur with dipyrone, a nonopioid analgesic popular in Europe, Asia and South America. ⋯ Dipyrone given for 5 days or longer blunts platelet inhibition by low-dose aspirin in the majority of recipients.
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Pleural effusion is a common finding in critically ill patients and may contribute to circulatory instability and the need for inotropic support. ⋯ In a porcine model of pleural effusion, dobutamine affected basic haemodynamic determinants substantially by decreasing left ventricular preload. Changes in central venous pressure and inferior vena cava characteristics were minimal, discouraging their use as indices of preload. This study underlines the significance of evaluating basic haemodynamic determinants to avoid inappropriate, potentially harmful treatment.