European journal of anaesthesiology
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Accurate assessment of a patient's volume status is an important goal for an anaesthetist. However, most variables assessing fluid responsiveness are either invasive or technically challenging. This study was designed to compare the accuracy of arterial pressure-based stroke volume variation (SVV) and variations in the pulse oximeter plethysmographic waveform amplitude as evaluated with the noninvasive calculated pleth variability index (PVI) with central venous pressure to predict the response of stroke volume index (SVI) to volume replacement in patients undergoing major surgery. ⋯ Although arterial pressure-derived SVV revealed the best correlation to volume-induced changes in SVI, the results of our study suggest that both variables, SVV and PVI, can serve as valid indicators of fluid responsiveness in mechanically ventilated patients undergoing major surgery.
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Randomized Controlled Trial
An opioid-free anaesthetic using nerve blocks enhances rapid recovery after minor hand surgery in children.
The aim of this prospective randomized study was to evaluate the quality of analgesia, postoperative comfort and subsequent duration of hospitalization after distal hand surgery and peripheral nerve block at the wrist for paediatric outpatients. ⋯ The present study demonstrates for the first time that, after distal hand surgery in children, peripheral nerve block improves pain management, opioid analgesia-induced side effects and provides a shorter postoperative recovery time than systemic analgesia with opioids.
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The present study investigated whether positioning of the heart during off-pump coronary artery bypass grafting leads to changes in regional cerebral oxygen saturation measured by near infrared spectroscopy. ⋯ Positioning of the heart during off-pump coronary artery bypass grafting leads to a decrease in regional cerebral oxygen saturation. This decrease is associated with changes in cardiac output, haemoglobin concentration, arterial CO2 partial pressure, and central venous pressure.
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In the past decade, 'airway management' has been recognized as an important focus in clinical anaesthesia in order to improve patient safety. The aim of the study was to retrieve data regarding the procurement, storage and preferences of airway management devices (AMDs) by anaesthesia departments in German hospitals. ⋯ The present survey regarding the availability of AMDs among German hospitals confirmed that airway management constitutes an important focus in the respondent anaesthesia departments. German hospitals seem to be well equipped with devices for the different scenarios in airway management.
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Letter Case Reports
Peripheral Tapia's syndrome after cardiac surgery.