European journal of anaesthesiology
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Observational Study
Anaesthesiological support in a cardiac electrophysiology laboratory: A single-centre, prospective observational study.
Implantation of cardiovascular implantable electronic devices (CIEDs) has greatly increased during the last decade and anaesthetic management of these patients remains an open question. ⋯ Patients requiring cardiovascular implantable electronic device (CIED) implantation were fragile with a high complication rate and a high rate of severe complications even with anaesthesiological support. These complications, as well as the need for deep sedation or general anaesthesia, clearly justify the involvement of a qualified anaesthesiologist.
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Long-term absolute and relative survival after aortic valve replacement: A prospective cohort study.
Aortic valve replacement is one of the most common cardiac surgical procedures, especially in elderly patients. Whether or not there is a net life gain over a long period of time is a matter for debate. ⋯ Patients who survived the first year after aortic valve replacement had a similar chance of survival as the matched normal population. Relative survival benefit was higher in the oldest age quartile.
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The pulse oximeter measurement pleth variability index (PVI) can detect hypovolaemia during positive pressure ventilation. ⋯ The PVI increased significantly for higher LBNP, but overlap was common regardless of breathing mode. The PVI can be used to indicate a hypovolaemic state during spontaneous breathing in groups but not in individuals.
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Randomized Controlled Trial
Low-dose neostigmine to antagonise shallow atracurium neuromuscular block during inhalational anaesthesia: A prospective randomised controlled trial.
Even shallow residual neuromuscular block [i.e. train-of-four (TOF) ratio around 0.6] is harmful. It can be effectively antagonised by small doses of neostigmine, but reports are limited to intravenous anaesthesia. Inhalational anaesthesia may enhance neuromuscular block and delay recovery. It is not known whether low doses of neostigmine are still effective in the context of inhalational anaesthesia. ⋯ Under desflurane anaesthesia, neostigmine 10 µg kg(-1) is effective in antagonising shallow atracurium block. Compared to no neostigmine, the time to a TOF ratio more than 0.9 was shortened and neuromuscular recovery at 5 and 10 min was more advanced.