European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Labour analgesia: a randomised, controlled trial comparing intravenous remifentanil and epidural analgesia with ropivacaine and fentanyl.
To compare the analgesic efficacy and side-effects of remifentanil intravenous patient-controlled analgesia (IVPCA) with walking epidural analgesia (EDA) during labour. ⋯ Remifentanil IVPCA and epidural provided effective analgesia, with high maternal satisfaction scores and reassuring neonatal outcome. Remifentanil produced more maternal sedation and oxygen desaturation. Close monitoring is, therefore, mandatory.
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A unifying hypothesis which satisfactorily explains the clinical syndrome of heart failure has proved elusive. A deeper understanding of the underlying pathophysiology has led to the development of more complex models and, as a result, the evolution of new treatment strategies. ⋯ Although vasodilators undoubtedly play a major role in the management of patients with heart failure, the relative importance of venodilatation remains unclear. The purpose of this article is to discuss the clinical evidence supporting the use of drugs with venodilating properties in surgical patients with heart failure.