European journal of anaesthesiology
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Elderly patients with heart failure undergoing urgent major surgery suffer substantial cardiac morbidity and mortality. Levosimendan, a novel calcium sensitizer, enhances myocardial contractility while simultaneously having vasodilatory and cardioprotective properties. This could be advantageous in perioperative management of heart failure patients. ⋯ In patients with heart failure, preoperative start of levosimendan infusion improves intraoperative and postoperative haemodynamics. These findings suggest that levosimendan is a useful drug for preoperative optimization of cardiac function in high-risk patients undergoing major surgery.
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Unlike for intensive care unit and home mechanical ventilators, no study has evaluated the user-friendliness of the recently introduced new anaesthesia workstations. ⋯ Anaesthesia machines have benefited from considerable advances in design and technology. This novel user-friendliness scale revealed that the most recent workstations were more appreciated by users than the first-generation of anaesthesia workstations. This user-friendliness scale may help the anaesthetic staff to 'consensually' choose the future workstation for their anaesthesia department.
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Randomized Controlled Trial Comparative Study
Comparison of dexmedetomidine-propofol vs. fentanyl-propofol for laryngeal mask insertion.
There have been many studies to find the optimum anaesthetics to provide excellent conditions for laryngeal mask insertion. We compared the effects of dexmedetomidine administered before propofol, on laryngeal mask insertion with fentanyl combined with propofol. ⋯ Dexmedetomidine, when used before propofol induction provides successful laryngeal mask insertion comparable to fentanyl, while preserving respiratory functions more than fentanyl.
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To evaluate the use of remifentanil-propofol administered as target-controlled infusion during awake fibreoptic intubation for anticipated difficult tracheal intubation in acromegalic patients. ⋯ Remifentanil and propofol target-controlled infusion provided satisfactory conscious sedation allowing for successful oral fibreoptic intubation in acromegalic patients with no recall.
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It has been reported that the left molar approach of laryngoscopy can make difficult intubation easier. The aim of this study was to investigate whether left molar approach to laryngoscopy provided a better laryngeal view in cases of unexpected difficult intubation. ⋯ Left molar laryngoscopy can make unexpected difficult intubation easier and should be attempted in cases of difficult intubation.