Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2021
Clinical TrialThe 90% effective dose of intranasal dexmedetomidine for procedural sedation in children with congenital heart disease before and after surgery: a biased-coin design up-and-down sequential allocation trial.
Intranasal dexmedetomidine can provide adequate sedation during short procedures. However, there are few reports investigating the effective dose of intranasal dexmedetomidine for sedation in children with congenital heart disease (CHD) before and after surgery. ⋯ The 90% effective dose of intranasal dexmedetomidine for sedation in children with CHD was 2.13 μg/kg before cardiac surgery and 3.51 μg/kg after cardiac surgery.
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Acta Anaesthesiol Scand · Feb 2021
Randomized Controlled Trial Multicenter StudyThe effect of remote ischaemic preconditioning on endothelial function after hip fracture surgery.
Endothelial dysfunction seems to play a role in the pathophysiology of myocardial injury after surgery. The aim of this randomised clinical trial was to examine whether remote ischaemic preconditioning in relation to hip fracture surgery ameliorates post-operative systemic endothelial dysfunction. ⋯ No beneficial effect of remote ischaemic preconditioning on the systemic endothelial dysfunction, assessed at a single time point on post-operative day one, was detected after hip fracture surgery.
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Acta Anaesthesiol Scand · Feb 2021
Randomized Controlled TrialThermal suit connected to a forced-air warming unit for preventing intraoperative hypothermia: a randomised controlled trial.
Inadvertent intraoperative hypothermia is a common occurrence in surgical patients. A thermal suit is an option for passive insulation. However, active warming is known to be more effective. Therefore, we hypothesised that a forced-air warming (FAW) unit connected to the thermal suit is superior to a commercial FAW blanket and a warming mattress in breast cancer surgery. ⋯ A thermal suit connected to a FAW unit was not superior to a commercial FAW blanket, although the incidence of intraoperative hypothermia was lower in patients treated with a thermal suit.
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Acta Anaesthesiol Scand · Feb 2021
ReviewInterpreting the results of clinical trials, embracing uncertainty: A Bayesian approach.
Most clinical trials use null hypothesis significance testing with frequentist statistical inference to report P values and confidence intervals for effect estimates. This method leads to a dichotomisation of results as 'significant' or 'non-significant'. ⋯ The use of Bayesian statistics is introduced in this paper for a hypothetical sepsis trial with worked examples in the R language for Statistical Computing environment and the open-source statistical software JASP. It is hoped that this general introduction to Bayesian inference stimulates some interest and confidence among clinicians to consider applying these methods to the interpretation of new evidence for interventions relevant to anaesthesia and intensive care medicine.
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Acta Anaesthesiol Scand · Feb 2021
EditorialTime to consider supraglottic airway device oropharyngeal leak pressure measurement more objectively.
Oropharyngeal leak pressure (OLP) is considered a measure of successful placement, adequate performance and is a useful comparator between supraglottic airway devices (SADs). OLP measurement is based on the premise that the SAD is sited properly in the hypopharynx after blind placements, but the evidence suggests otherwise. Several limitations and controversies surround OLP. This editorial addresses the uses and pitfalls of OLP, the rationale for and methods of ascertaining OLP, the pros and cons of OLP measurement and newer modalities to improve its accuracy.