Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Metabolic, hormonal and gastric fluid and pH changes after different preoperative feeding regimens.
To evaluate the metabolic, hormonal and gastric fluid and pH changes after administration of a small volume of different preoperative feeding regimens. ⋯ Small volumes of fluid increased RGV (P < 0.05). Apple juice resulted in increased incidence of thirst and hunger and plasma glucose and norepinephrine concentrations. Compared with GFSM or apple juice, honey had a gentler effect on plasma glucose and insulin concentrations.
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Review
Safety and efficacy of o-raffinose cross-linked human hemoglobin (Hemolink) in cardiac surgery.
There are currently two major classes of oxygen therapeutics: hemoglobin based oxygen carriers (HBOCs) and synthetic perfluorocarbons (PFCs). This review focuses on the use of o-raffinose cross-linked human hemoglobin (Hb raffimer) in cardiac surgery. ⋯ The converging evidence from clinical studies with HBOCs has demonstrated that these products have the potential to provide hemoglobin and oxygen carrying capacity to tissues in times of acute anemia during surgery. It is anticipated that Hb raffimer will be used to facilitate intraoperative autologous donation and emerge as an important alternative to allogeneic blood transfusion during cardiac surgery.
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Cardiothoracic surgeons and anesthesiologists have had a long-standing interest in the proper use of transfusion therapy for their patients. ⋯ Issues such as the cost of blood, limited availability and the potentially harmful effects of transfusion dictate continued research and the development of methods to appropriately minimize transfusion to patients having cardiac surgery.
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Randomized Controlled Trial Clinical Trial
Single dose diclofenac suppository reduces post-Cesarean PCEA requirements.
To assess the analgesic efficacy of administering, immediately after surgery, a single dose of diclofenac (100 mg suppository) to women who had undergone lower segment Cesarean section (LSCS) under combined spinal-epidural anesthesia, and received post-operative patient-controlled epidural analgesia (PCEA) with ropivacaine 0.2% and fentanyl 2 microg x ml(-1). ⋯ A single administration of 100 mg diclofenac suppository is effective in reducing post-Cesarean epidural local anesthetic/opioid requirements by 33% for the first 24 hr post-operatively.
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We review the clinically important benefits of the two principal pharmacological strategies, erythropoietin (EPO) and antifibrinolytics (aprotinin and lysine analogues), to decrease transfusion of allogeneic blood products (ABP) during and after cardiac surgery. ⋯ We still need large scale studies to definitely confirm the benefits and exclude the deleterious effects of these drugs on outcomes other than ABP requirements. At present, aprotinin is the only agent that has been shown to reduce the risk of cerebrovascular accident and mortality after cardiac surgery in adults.