Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 2011
Randomized Controlled Trial Multicenter Study Comparative StudyEfficacy and safety of hydroxyethyl starch 6% 130/0.4 in a balanced electrolyte solution (Volulyte) during cardiac surgery.
The infusion of large amounts of saline-based solutions may contribute to the development of hyperchloremic metabolic acidosis and the use of a balanced carrier for colloid solutions might improve postoperative acid-base status. The equivalence of 2 hydroxyethyl starch (HES) solutions and the influence on chloride levels and acid-base status by selectively changing the carrier of rapidly degradable modern 6% HES 130/0.4 were studied in cardiac surgery patients. ⋯ Volumes of HES needed for hemodynamic stabilization were equivalent between treatment groups. Significantly lower serum chloride levels in the HES balanced group reflected the lower chloride load of similar infusion volumes. The HES balanced group had significantly less acidosis.
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J. Cardiothorac. Vasc. Anesth. · Jun 2011
Randomized Controlled Trial Comparative StudyLevosimendan in congenital cardiac surgery: a randomized, double-blind clinical trial.
In this study, the authors used a continuous infusion of either levosimendan or milrinone as inotropic support after corrective congenital cardiac surgery. The hemodynamic and biochemical parameters were compared. ⋯ Levosimendan is at least as efficacious as milrinone after corrective congenital cardiac surgery in neonates and infants.
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J. Cardiothorac. Vasc. Anesth. · Jun 2011
Randomized Controlled Trial Comparative StudyThoracic epidural anesthesia and analgesia during the perioperative period of thoracic surgery: levobupivacaine versus bupivacaine.
To compare the effects of thoracic epidural anesthesia with levobupivacaine or bupivacaine on block features, intraoperative hemodynamics, and postoperative analgesia for thoracic surgery. ⋯ Thoracic epidural anesthesia with either levobupivacaine or bupivacaine provided comparable sensory block features, intraoperative hemodynamics, and postoperative analgesia for thoracic surgery.
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J. Cardiothorac. Vasc. Anesth. · Jun 2011
Randomized Controlled Trial Comparative StudyIntraoperative infusion of S(+)-ketamine enhances post-thoracotomy pain control compared with perioperative parecoxib when used in conjunction with thoracic paravertebral ropivacaine infusion.
The authors explored the use of continuous postoperative subpleural paravertebral ropivacaine alone combined with intraoperative S(+)-ketamine or perioperative parecoxib as a new approach to pain control after major thoracotomy. ⋯ In patients with thoracotomy, postoperative paravertebral ropivacaine combined with intraoperative S(+)-ketamine provided better early postoperative pain relief than ropivacaine and perioperative parexocib or ropivacaine alone.
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J. Cardiothorac. Vasc. Anesth. · Jun 2011
Multicenter Study Comparative StudyAnesthetic management of transcatheter aortic valve implantation with transaxillary approach.
To describe the anesthetic management of transcatheter aortic valve implantation (TAVI) with the transaxillary approach. ⋯ Transaxillary TAVI is feasible in high-risk patients with aortic stenosis and peripheral vasculopathy. Nevertheless, severe procedural complications are possible, and anesthesiologists should be prepared to assist in the management of these conditions.