European journal of anaesthesiology
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Observational Study
Pain assessment in the postanaesthesia care unit using pupillometry: A cross-sectional study after standard anaesthetic care.
Patients assess their own pain with a numerical rating scale (NRS). In the postanaesthesia care unit (PACU), NRS helps to determine and monitor analgesic administration, but is useless in patients who are unable to communicate. In non-PACU patients, acute pain increases pupillary diameter and pupillary light reflex amplitude (PLRA), the difference between pupillary diameter before and after light stimulation. ⋯ Acute postoperative pain is not associated with pupillary diameter or PLRA. Further research is required to develop tools to assess pain in the PACU.
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Observational Study
Validation of rotational thromboelastometry during cardiopulmonary bypass: A prospective, observational in-vivo study.
Rotational thromboelastometry (ROTEM) is a whole blood point-of-test used to assess the patient's coagulation status. Three of the available ROTEM tests are EXTEM, INTEM and HEPTEM. In the latter, heparinase added to the INTEM reagent inactivates heparin to reveal residual heparin effect. Performing ROTEM analysis during cardiopulmonary bypass (CPB) might allow the anaesthesiologist to anticipate the need for blood products. ⋯ HEPTEM and EXTEM measurements are valid in the presence of very high heparin concentrations and can be performed before protamine administration in patients undergoing cardiac surgery with CPB.
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Observational Study
Preoperative urine-specific gravity and the incidence of complications after hip fracture surgery: A prospective, observational study.
Mild to moderately severe dehydration is common in the elderly, but its relationship to surgical outcome is unclear. ⋯ Dehydration before surgery nearly quadrupled the number of postoperative complications after hip fracture repair.
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Observational Study
Accuracy and precision of commonly used methods for quantifying surgery-induced insulin resistance.
Insulin resistance develops in the perioperative setting and has an adverse influence on postoperative recovery and well-being. ⋯ Despite reasonably good linear correlations, the static tests grossly underestimated the degree of insulin resistance that developed in response to surgery.