European journal of anaesthesiology
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In high-bleeding risk procedures, discontinuation of antiplatelet drug therapy with clopidogrel may be requested by surgeons, usually 7-10 days before the surgical procedure. New platelet function tests, such as the vasodilator-stimulated phosphoprotein phosphorylation assay, may help to assess the perioperative status of the clopidogrel-specific P2Y12 receptor. ⋯ The study using vasodilator-stimulated phosphoprotein phosphorylation assay, one of the new platelet function assays for the assessment of inhibition of platelet P2Y12 receptor, demonstrates that the PRI on day 5 after discontinuation of clopidogrel is equivalent to a surgical control group and it questions the rigid practice of delaying surgery for 7-10 days, particularly in patients without a clopidogrel effect.
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Randomized Controlled Trial Comparative Study
Management of the predicted difficult airway: a comparison of conventional blade laryngoscopy with video-assisted blade laryngoscopy and the GlideScope.
We investigated whether the use of two different video laryngoscopes [direct-coupled interface (DCI) video laryngoscope and GlideScope] may improve laryngoscopic view and intubation success compared with the conventional direct Macintosh laryngoscope (direct laryngoscopy) in patients with a predicted difficult airway. ⋯ We conclude that the video laryngoscope and GlideScope in particular may be useful instruments in the management of the predicted difficult airway.
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Systemically administered lidocaine has been shown to have anti-inflammatory properties. Inhalation is an attractive way of application because of high pulmonary compound concentrations and potentially fewer systemic side effects. The aim of this study was to clarify whether inhaled or, likewise, intravenous lidocaine can attenuate the inflammatory response in a model of experimental endotoxaemia in the rat. ⋯ Pretreatment of endotoxaemic rats either with Lid(Ae4.0) or with Lid(iv) attenuated the levels of proinflammatory mediators in bronchoalveolar lavage fluid. Plasma cytokine levels were not affected. Nebulized lidocaine (0.4 mg kg(-1)) inhibited the nitrite release but did not affect the cytokine levels.