European journal of anaesthesiology
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Intensive insulin therapy reduced mortality in patients admitted to an intensive care unit following mainly cardiac surgery. The aim of this prospective study was to evaluate, if intensive insulin therapy could reduce mortality in medical and non-cardiac surgical patients admitted to a multidisciplinary intensive care unit. ⋯ Following intensive insulin therapy there was a trend towards reduced mortality in medical and non-cardiac surgical patients but less pronounced as in cardiac surgical patients. Intensive insulin therapy increased the frequency of hypoglycaemia. Around 4400 patients would have to be included in any future randomized study to reach significance.
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Randomized Controlled Trial Comparative Study
Sensory blockade after thoracic paravertebral injection of ropivacaine or bupivacaine.
No clinical trials comparing the characteristics of sensory blockade caused by various local anaesthetics in thoracic paravertebral blockade have been published. The aim of this prospective study was a clinical assessment of sensory blockade after paravertebral injection of ropivacaine or bupivacaine in patients undergoing modified radical mastectomy. ⋯ Both agents provide satisfactory conditions for mastectomy, but ropivacaine seems to be superior to bupivacaine for thoracic paravertebral blockade during breast cancer surgery.
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Randomized Controlled Trial
Fluid preload before spinal anaesthesia in Caesarean section: the effect on neonatal acid-base status.
We evaluated the effect of two different preload solutions: (i) Ringer's lactate (compound sodium lactate intravenous infusion BP) and (ii) 0.9% sodium chloride solution on the neonatal acid-base status of the newborn infants. The two standard regimens were compared to detect a possible difference. ⋯ The choice of Ringer's lactate or saline for fluid preload does not have any effect on neonatal well-being.
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Review
Cardiac risk reduction in non-cardiac surgery: the role of anaesthesia and monitoring techniques.
Cardiac complications are the major cause of perioperative morbidity and mortality of patients undergoing non-cardiac surgery. This is related to the frequent presence of underlying coronary artery disease. ⋯ On the other hand, less attention was given to the role of anaesthesia and monitoring techniques in the cardiac risk management of high-risk patients undergoing non-cardiac surgery. The aim of this review was to summarize the current evidence from published studies on the effect of the type of anaesthesia and monitoring techniques on perioperative cardiac outcome in non-cardiac surgery.