European journal of anaesthesiology
-
Randomized Controlled Trial
Synergistic effect of the association between lidocaine and magnesium sulfate on peri-operative pain after mastectomy: A randomised, double-blind trial.
Recently, the use of venous adjuvants, such as lidocaine and magnesium sulfate, has been gaining ground in multimodal analgesia. However, no study has evaluated the impact a combination of the two drugs. ⋯ Our findings suggest a synergistic effect of the use of both lidocaine and magnesium in peri-operative pain. This may be another potential strategy in the multimodal analgesia regimen.
-
Randomized Controlled Trial
Deep neuromuscular blockade during spinal surgery reduces intra-operative blood loss: A randomised clinical trial.
Spinal surgery is usually performed in the prone position using a posterior approach. However, the prone position may cause venous engorgement in the back and thus increase surgical bleeding with interruption of surgery. The prone position also affects cardiac output since large vessels are compressed decreasing venous return to the heart. ⋯ Deep neuromuscular blockade reduced intra-operative surgical bleeding in patients undergoing spinal surgery. This may be related to greater relaxation in the back muscles and lower intra-operative peak inspiratory pressure when compared with moderate neuromuscular blockade.
-
Randomized Controlled Trial
Postoperative residual neuromuscular blockade after reversal based on a qualitative peripheral nerve stimulator response: A randomised controlled trial.
Incomplete recovery of neuromuscular blockade is a common postoperative adverse event in the postanaesthesia care unit. ⋯ The incidence of residual neuromuscular blockade on arrival in the recovery room was significantly higher in the neostigmine group than that in the sugammadex group. However, the incidence of adverse events was similar in the neostigmine and sugammadex groups.
-
Postoperative autologous retransfusion of drainage blood might reduce the transfusion of red blood cell concentrates after major orthopaedic surgery. ⋯ Our study questions the effectiveness of postoperative autotransfusion as part of a patient blood management programme. In addition, the obvious signs of inflammatory reactions and coagulation activation raise safety concerns.
-
Heparin-associated coagulation disorder is an important factor related to postoperative bleeding in patients undergoing cardiac surgery with cardiopulmonary bypass. Currently, the relationship between heparin sensitivity and postoperative bleeding is unknown. ⋯ Postoperative blood loss is related to heparin sensitivity in patients undergoing cardiac surgery, and the moderately sensitive patients have the least postoperative bleeding. Individual variation in heparin sensitivity is related to the mRNA and plasma levels of AT-III and factor X.