European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Total intravenous anaesthesia with ketamine-midazolam versus halothane-nitrous oxide-oxygen anaesthesia for prolonged abdominal surgery.
Total intravenous anaesthesia (TIVA) with ketamine-midazolam (KM) can be used for prolonged abdominal surgery. We compared this technique with halothane-nitrous oxide-oxygen anaesthesia using haemodynamic and endocrine stress responses as primary outcomes and adequacy of operating conditions and recovery profile as secondary outcomes. ⋯ The stress responses during KM anaesthesia for prolonged abdominal surgery were comparable to those during halothane-nitrous oxide-oxygen anaesthesia. However, KM anaesthesia provided better surgical conditions and better recovery.
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Randomized Controlled Trial Clinical Trial
Implications of the use of neuromuscular transmission monitoring on immediate postoperative extubation in off-pump coronary artery bypass surgery.
When continuous infusions of neuromuscular blocking drugs are administered during lengthy interventions and no routine antagonism of their effects is applied, there is a dramatic incidence of residual curarization. We have examined whether the use of neuromuscular transmission monitoring results in differences in the incidence of postoperative residual curarization, the use of antagonist agents, and the endotracheal extubation rate and outcome after continuous infusion of rocuronium in patients undergoing off-pump coronary artery bypass surgery. ⋯ Although we found no additional benefit of using neuromuscular transmission monitoring, it seems an absolute necessity for safety reasons. Pharmacological antagonism was mandatory. However, in our opinion, it is not wise routinely to perform immediate postoperative extubation in off-pump coronary artery bypass surgery.