Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2015
Association of CYP450 single nucleotide polymorphisms with the efficacy of epidural ropivacaine during mastectomy.
Ropivacaine is frequently used for local anesthesia in the clinic and is metabolized by cytochrome P450 (CYP450) in the liver. CYP450 polymorphisms may alter the therapeutic efficacy of drugs in patients. In this study, we selected six CYP450 polymorphisms from the dbSNP and HapMap databases, using a combination of functional analysis and Tag SNP strategies and examined these polymorphisms for association with the efficacy of epidural ropivacaine in patients during mastectomy. ⋯ Our present data demonstrate that CYP1A2 SNPs rs11636419 and rs17861162 alter the sensitivity of epidural ropivacaine in patients undergoing breast cancer surgery. As such, detection of these two CYP1A2 SNPs may aid in the development of effective personalized treatments for breast cancer patients.
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Acta Anaesthesiol Scand · May 2015
Randomized Controlled TrialEffect of high-volume systematic local infiltration analgesia in Caesarean section: a randomised, placebo-controlled trial.
Local infiltration with either 50mL 0.5% or 125mL 0.2% ropivacaine did not improve post-operative pain after elective caesarean section.
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Acta Anaesthesiol Scand · May 2015
ReviewThe demise of early goal-directed therapy for severe sepsis and septic shock.
A protocol for the quantitative resuscitation of severe sepsis and septic shock known as early goal-directed therapy (EGDT) was published in 2001. Despite serious limitations, this study became widely adopted around the world and formed the basis of the Surviving Sepsis Campaign 6 h resuscitation bundle. Subsequently, a large number of observational before-and-after studies were published which demonstrated that EGDT reduced mortality. ⋯ Furthermore, accruing data suggest an association between the amount of fluid administered in the first 72 h and the mortality of patients with severe sepsis. Patients in all arms of the ProCESS and ARISE trials received substantial and nearly equivalent amounts of fluid. It is proposed that a more conservative fluid strategy and the earlier use of norepinephrine in patients with septic shock may be associated with further improvements in the outcome of patients with sepsis.
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Acta Anaesthesiol Scand · May 2015
Implementation and preliminary validation of a new score that predicts post-operative complications.
An accurate pre-operative risk assessment could reduce morbidity and mortality for high-risk surgical patients. The aim of the study was to implement and preliminary validate a new score that could predict the occurrence of post-operative complications (PoCs): the Anesthesiological and Surgical Postoperative Risk Assessment (ASPRA) score. ⋯ The new ASPRA score has a high positive predictive value to predict the occurrence of PoCs. Further prospective studies are required to confirm these results.
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Acta Anaesthesiol Scand · May 2015
Renal haemodynamic response to amino acids infusion in an experimental porcine model of septic shock.
Acute kidney injury (AKI) is common in sepsis. Treatments allowing maintenance of renal blood flow (RBF) could help to prevent AKI associated with renal hypoperfusion. Amino acids (AA) have been associated with an increase of RBF and glomerular filtration rate (GFR) in several species. The aim of this study was to evaluate the effects of an AA infusion on RBF and GFR in a porcine model of septic shock. ⋯ An infusion of amino acids impaired renal haemodynamics in this experimental model of septic shock.