European journal of anaesthesiology
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Randomized Controlled Trial Clinical Trial
The effect of lidocaine on neutrophil respiratory burst during induction of general anaesthesia and tracheal intubation.
Respiratory burst is an essential component of the neutrophil's biocidal function. In vitro, sodium thiopental, isoflurane and lidocaine each inhibit neutrophil respiratory burst. The objectives of this study were (a) to determine the effect of a standard clinical induction/tracheal intubation sequence on neutrophil respiratory burst and (b) to determine the effect of intravenous lidocaine administration during induction of anaesthesia on neutrophil respiratory burst. ⋯ Induction of anaesthesia and tracheal intubation using thiopentone and isoflurane, inhibit neutrophil respiratory burst. This effect may be diminished by the administration of lidocaine.
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Randomized Controlled Trial Clinical Trial
Low-flow anaesthesia with desflurane: kinetics during clinical procedures.
Low-flow anaesthesia is economical and less polluting. The purpose of this study was to determine the inspired and end-tidal desflurane concentrations during anaesthesia with a vaporizer setting maintained at 5%, during low-flow anaesthesia after 120 min with fresh gas inflows of 1.0 and 2.0 L min-1. ⋯ There is a significant difference between the inspired and end-tidal concentrations of desflurane when fresh gas inflows were 1.0 and 2.0 L min-1, but not for the ratio of inspired/end-tidal.
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As is often the case in medicine, the risk to benefit ratio of blood transfusion requires careful examination. The decision to transfuse a patient cannot be based only on the haemoglobin or the haematocrit concentration. ⋯ In the absence of a universal transfusion trigger, decision to transfuse a patient with an haemoglobin concentration between 7.0 and 10.0 g dL-1 depends primarily on clinical judgement. With the exception of emergency situations, blood transfusion will be realized on a unit-by-unit basis, and the efficacy of treatment should be evaluated after each transfused unit.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of five solutions of local anaesthetics and/or sufentanil for continuous, postoperative epidural analgesia after major urological surgery.
The aim of the present study was to compare and assess the quality of analgesia, the safety and the side-effects after the use of a continuous, thoracic epidural infusion of sufentanil (5 microg h(-1)), 0.25% bupivacaine (10 mL h(-1)), 0.2% ropivacaine (10 mL h(-1)) alone or in combination in patients who had undergone major urological surgery. This prospective, randomized, double-blinded study investigated the efficacy of thoracic epidural infusions after major urological surgery. ⋯ A continuous, epidural infusion with these drugs was safe and effective in our patients. The combination of 0.2% ropivacaine plus sufentanil appeared preferable because of the low incidence of motor block.
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Comparative Study Clinical Trial
Minimal-flow anaesthesia with controlled ventilation: comparison between laryngeal mask airway and endotracheal tube.
Minimal- and low-flow anaesthesia (fresh gas flow below 1 L min(-1)) provide many advantages, including reduced cost, conservation of body heat and airway humidity. An airtight seal is essential between the airway device and the airway of the patient. Therefore, we investigated whether the airtight seal created by a laryngeal mask airway allows controlled ventilation of the lungs when the fresh gas flow is reduced to 0.5 L min(-1) and compared this with an endotracheal tube. ⋯ The use of the laryngeal mask airway was more likely to be associated with a gas leak than use of an endotracheal tube; however, if modern anaesthesia machines and monitors are used, in 96.7% of the patients managed with a laryngeal mask a reduction in the fresh gas flow to 0.5 L min(-1) was possible. The incidence of coughing and postoperative complaints (sore throat, swallowing problems) was higher after use of an endotracheal tube.