European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study
Levobupivacaine 0.75% vs. lidocaine 4% for topical anaesthesia: a clinical comparison in cataract surgery.
The aim of this study was to compare the efficacy of topical levobupivacaine drops 0.75% vs. lidocaine drops 4% in cataract surgery. ⋯ Topical levobupivacaine 0.75% shows the same efficacy and safety as lidocaine 4% in cataract surgery by phacoemulsification. There was an adequate block with a good level of satisfaction of surgeon and patients. Levobupivacaine 0.75% offers a new and acceptable choice for topical anaesthesia in cataract surgery.
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Randomized Controlled Trial
Effect of dexmedetomidine on bleeding during tympanoplasty or septorhinoplasty.
The aim of this study was to evaluate the efficacy of dexmedetomidine, an alpha(2)-adrenoceptor agonist, on intraoperative bleeding, anaesthetic drug requirement and postoperative pain. ⋯ Dexmedetomidine decreased bleeding, postoperative analgesic requirements and intraoperative anaesthetic requirements and was associated with more stable haemodynamic responses to anaesthesia. We conclude that dexmedetomidine is a useful adjuvant to decrease bleeding when a bloodless surgical field is requested.
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Randomized Controlled Trial
Does adding intravenous fentanyl to caudal block in children enhance the efficacy of multimodal analgesia as reflected in the plasma level of catecholamines?
Several studies showed that single analgesic modality management can attenuate perioperative stress, but little is known about the effect of multimodal analgesia on catecholamine responses to surgical trauma in children. ⋯ These findings suggest that the multimodal analgesic approach of adding i.v. low-dose fentanyl to a caudal block may decrease the plasma epinephrine release in children undergoing inguinal herniotomy.
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The objective of this study was to determine the intracranial, cardiovascular and respiratory changes induced by conversion to high-frequency oscillator ventilation from conventional mechanical ventilation at increasing airway pressures. ⋯ The use of high positive end expiratory pressure with conventional mechanical ventilation or high continuous distending pressure with high-frequency oscillator ventilation increased intracranial pressure and adversely affected cerebral metabolic indices in this ovine model. Transcranial Doppler is a useful adjunct to intracranial pressure and intracranial venous saturation monitoring when major changes in ventilation strategy are adopted.