Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2018
Comparative Study Observational StudyS100β in newborns after C-section with general vs. epidural anesthesia: a prospective observational study.
Preclinical evidence suggests that general anesthetics can dose dependently induce neurodegeneration in the developing brains of animals which can be reliably determined by measurement of blood S100β, but this correlation remains unclear in humans. We hypothesized that S100β would not be increased in cord arterial blood of fetuses exposed briefly to general anesthetics during a C-section, compared with epidural anesthesia. ⋯ S100β levels in newborn after C-section is lower with general anesthesia than epidural anesthesia, with unclear mechanisms.
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Acta Anaesthesiol Scand · Mar 2018
Randomized Controlled Trial Comparative StudyInsertion methods comparison for The Streamlined Liner of the Pharynx Airway in children by novice.
The Streamlined Liner of the Pharynx Airway (SLIPA™) is a popular supraglottic airway device used for pediatric anesthesia. However, based on the anatomical features of pediatric patients, novice residents are expected to have difficulties inserting the device. The objective of this work was to improve the SLIPA insertion by modifying the device. ⋯ The 120° bend improved SLIPA insertion when performed by novice, as reflected by higher insertion success rates and shorter insertion times, with no statistical differences in hemodynamic response to insertion or the incidence rates of complications between the two groups.
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Acta Anaesthesiol Scand · Mar 2018
4218T/C polymorphism associations with post-cesarean patient-controlled epidural fentanyl consumption and pain perception.
The utilization of intrathecal opioids is an efficacious component of post-cesarean section pain management. Given that growing evidence indicates that calcitonin gene-related peptide (CGRP) plays a key role in the development of peripheral sensitization and is associated with enhanced pain, we hypothesized that CGRP 4218T/C polymorphism is associated with the variability in fentanyl consumption for post-cesarean analgesia. ⋯ These results indicated that patients with C/C genotype may have reduced sensitivity to fentanyl analgesia and/or increased pain perception, and were more willing to use PCEA fentanyl to manage their pain.
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Acta Anaesthesiol Scand · Mar 2018
Randomized Controlled TrialSpecific anesthesia-induced lung volume changes from induction to emergence: a pilot study.
Studies aimed at maintaining intraoperative lung volume to reduce post-operative pulmonary complications have been inconclusive because they mixed up the effect of general anesthesia and the surgical procedure. Our aims were to study: (1) lung volume during the entire course of anesthesia without the confounding effects of surgical procedures; (2) the combination of three interventions to maintain lung volume; and (3) the emergence phase with focus on the restored activation of the respiratory muscles. ⋯ A combined intervention consisting of LRM, PEEP and CPAP during emergence may effectively maintain EELV during anesthesia and even after extubation. An unexpected finding was that the activation of the expiratory muscles may contribute to EELV reduction during the emergence phase.