European journal of anaesthesiology
-
Randomized Controlled Trial Comparative Study
The effect of scalp block and local infiltration on the haemodynamic and stress response to skull-pin placement for craniotomy.
The insertion of skull pins into the periosteum induces not only a haemodynamic response but also an increase in stress hormones. We compared the effects of scalp-nerve block, infiltration anaesthesia, and routine anaesthesia during skull-pin insertion on haemodynamic and stress responses to craniotomy. ⋯ We conclude that scalp block using 0.5% bupivacaine blunts the haemodynamic and stress responses to head pinning better than routine anaesthesia or scalp infiltration with bupivacaine and should be considered in conjunction with general anaesthesia for craniotomy.
-
Randomized Controlled Trial
Effects of changes in blood pressure and airway pressures on parameters of fluid responsiveness.
Systolic pressure variation (SPV) and stroke volume variation (SVV) are clinical indicators of fluid responsiveness. However, several factors may influence these parameters and thereby limit their usefulness. In this clinical study, we analysed SPV and SVV in comparison with static preload parameters during an increase in arterial blood pressure (BP) and airway pressure. ⋯ In cardiac surgical patients with preserved cardiac index, SVV, but not SPV, decreased during an acute increase in BP, whereas both parameters, in contrast to cardiac filling pressures, significantly increased with higher tidal volume.
-
Randomized Controlled Trial Comparative Study
Comparison of two different techniques of fibreoptic intubation.
The application of analgesics and sedatives during fibreoptic intubation (FOI) may result in a transient decrease in arterial oxygen saturation.This study evaluates two different techniques of FOI and respective effects on procedural duration, arterial oxygen saturation, and coughing by the patient. ⋯ The VAP technique decreases overall intubation time, increases the oxygen saturation of the patient until completion of the intubation, and reduces cough.
-
Primary brain tumours may be associated with coagulation disorders, which can pose intraoperative and postoperative management difficulties. Thromboelastography is a useful technique for evaluating coagulability. In this study, we evaluated the perioperative coagulation profile using both standard laboratory work and thromboelastography in paediatric patients undergoing craniotomy for primary brain tumours. ⋯ Thromboelastography may be useful in the perioperative assessment and monitoring of coagulation in paediatric neurosurgical patients and helps in identifying patients at increased risk of bleeding or thromboembolic events.
-
Letter Case Reports
Delayed reversal of a potentiated rocuronium neuromuscular block.