European journal of anaesthesiology
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Randomized Controlled Trial
Dexmedetomidine and postoperative shivering in patients undergoing elective abdominal hysterectomy.
Post-anaesthetic shivering is one of the most common complications, occurring in 5-65% of patients recovering from general anaesthesia and 33% of patients receiving epidural anaesthesia. Our objective was to investigate the efficacy of intraoperative dexmedetomidine infusion on postoperative shivering. ⋯ Intraoperative dexmedetomidine infusion may be effective in the prevention of post-anaesthetic shivering.
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Comparative Study
Changing from a specialized surgical observation unit to an interdisciplinary surgical intensive care unit can reduce costs and increase the quality of treatment.
In Germany there is considerable variability in the organizational forms of intensive-care medicine. We present economical data that arose during the reorganization of an intensive care unit with the implementation of the continuous presence of a trained intensivist. The unit was changed from an intensive-observational unit managed by four surgical departments without continuous presence of a trained intensivist to an interdisciplinary surgical intensive care unit managed by the Department of Anaesthesia in co-operation with the surgical departments with the continuous presence of trained intensivists. ⋯ In addition to the medical advantages, staffing the intensive care unit with trained intensivists 24 h a day was of appreciable economical benefit.
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alpha(2)-Adrenoceptor agonists administered into the intrathecal and epidural space have been found to be effective in the treatment of chronic pain. Moreover, it was shown that they increase the analgesic effects of local anaesthetics and provide sedation, anxiolysis and haemodynamic stability. Dexmedetomidine, a potent and highly selective alpha(2)-adrenoceptor agonist, is in current clinical use, particularly in the intensive care unit. Our aim was to investigate whether dexmedetomidine produced motor and sensory blockade and neurotoxic effects when administrated via the epidural catheter in rabbits. ⋯ We observed that dexmedetomidine does not have motor and sensory effects, but it may have a harmful effect on the myelin sheath when administered via the epidural route.
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Comparative Study
Comparative study of pressure- and volume-controlled ventilation on pulse pressure variation in a model of hypovolaemia in rabbits.
Dynamic indices represented by systolic pressure variation and pulse pressure variation have been demonstrated to be more accurate than filling pressures in predicting fluid responsiveness. However, the literature is scarce concerning the impact of different ventilatory modes on these indices. We hypothesized that systolic pressure variation or pulse pressure variation could be affected differently by volume-controlled ventilation and pressure-controlled ventilation in an experimental model, during normovolaemia and hypovolaemia. ⋯ Under normovolaemia and moderate haemorrhage, dynamic parameters were not influenced by either ventilatory modalities. However, in the second stage of haemorrhage (30%), animals in volume-controlled ventilation presented higher values of systolic pressure variation and pulse pressure variation when compared with those submitted to pressure-controlled ventilation.
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Our aim was to investigate the cytoprotective effect of propofol against hydrogen peroxide (H2O2)-mediated injury and the effects on the haeme oxygenase-1 system, which is a possible new cytoprotective pathway of propofol. ⋯ Propofol can protect cardiomyocytes against H2O2-mediated cytotoxicity in a dose-dependent manner and increase haeme oxygenase-1 expression, which may partly mediate the cytoprotective effects of propofol.