European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
A comparison of the analgesic efficacy of local infiltration analgesia vs. intrathecal morphine after total knee replacement: A randomised controlled trial.
Local infiltration analgesia (LIA) is an effective pain management technique following total knee arthroplasty (TKA). ⋯ We conclude that LIA conferred superior analgesia compared with intrathecal morphine 0.3 mg at 24 and 48 h following TKA.
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Observational Study
The haemodynamic instability score: Development and internal validation of a new rating method of intra-operative haemodynamic instability.
There is no consensus on how to define haemodynamic instability during general anaesthesia. Patients are often classified as stable or unstable based solely on blood pressure thresholds, disregarding the degree of instability. Vasoactive agents and volume therapy can directly influence classification but are usually not considered. ⋯ We developed the HI-score and demonstrated that it can appropriately quantify the degree of intra-operative haemodynamic instability. The HI-score provides a clinical tool which, after further external validation, may have future applications in both patient management and clinical research.
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Hypotension after spinal anaesthesia is a common side effect that may be harmful. Patients' susceptibility to intra-operative hypotension can be affected by many pre-operative factors. ⋯ Pre-operative IVCCI and IVC : Ao index are good predictors of the occurrence of PSAH. However, IVC : Ao index is a more powerful predictor than IVCCI.