European journal of anaesthesiology
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Observational Study
Near-infrared spectroscopy and processed electroencephalogram monitoring for predicting peri-operative stroke risk in cardiothoracic surgery: An observational cohort study.
Stroke is a feared complication after cardiothoracic surgery, with an incidence of around 2 to 3%. Anaesthesia and postoperative sedation may obscure clinical symptoms of stroke and thus delay diagnosis and timely intervention. ⋯ Cumulative intra-operative BIS values below 25 and longer duration of MAP below 60 mmHg were associated with the occurrence of peri-operative stroke within 3 days after cardiothoracic surgery. Prospective studies are warranted to evaluate a causal relationship between low BIS and stroke to establish whether avoiding intra-operative BIS values below 25 might reduce the incidence of peri-operative stroke.
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Subarachnoid haemorrhage (SAH) is a life-threatening condition with associated brain damage. Moreover, SAH is associated with a massive release of catecholamines, which may promote cardiac injury and dysfunction, possibly leading to haemodynamic instability, which in turn may influence a patient's outcome. ⋯ About one in five patients with SAH develops cardiac dysfunction, which seems to be associated with higher in-hospital mortality. The consistency of cardiac and neurological data reporting is lacking, reducing the comparability of the studies in this field.
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Randomized Controlled Trial Multicenter Study
Efficacy and safety of HSK3486 vs. propofol for the induction and maintenance of general anaesthesia: A multicentre, single-blind, randomised, parallel-group, phase 3 clinical trial.
HSK3486 (ciprofol) is a 2,6-disubstituted phenol derivative that acts like propofol as an agonist at the gamma-aminobutyric acid-A (GABA A ) receptor. ⋯ HSK3486 had a noninferior efficacy profile compared to propofol, exhibiting excellent tolerance.
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Ultrasound-guided, internal jugular venous (IJV) cannulation is a core technical skill for anaesthesiologists and intensivists. ⋯ A set of valid, reliable objective performance metrics has been developed for ultrasound-guided IJV cannulation. Considerable skill variability underlines the need to develop a CAI simulation-training programme using these metrics.
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Comment Letter Randomized Controlled Trial
Reply to: exploring cardiac effects after oxytocin 2.5 IU or carbetocin 100 μg - a randomised controlled trial in women undergoing planned caesarean delivery.