Der Anaesthesist
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Randomized Controlled Trial Comparative Study Clinical Trial
[Injection pain from propofol-MCT-LCT in children. A comparison with propofol-LCT].
This prospective, randomised, double-blind study was designed to compare the incidence and intensity of pain on injection of propofol formulated in a mixture of medium- and long-chain triglycerides, Propofol-MCT/LCT 1% (Propofol-Lipuro, B. Braun, Germany) with propofol in a commonly used emulsion of long-chain triglycerides, Propofol-LCT 1% (Disoprivan, Zeneca) in children undergoing elective surgical procedures. ⋯ Propofol-MCT/LCT 1% (Propofol-Lipuro) for induction of anesthesia produced significantly less pain on injection and significantly less drawing back of the arm when compared to Propofol-LCT (Disoprivan). Thus, with respect to pain on injection Propofol-MCT/LCT appears to be superior to Propofol-LCT in children aged 7-14 years.
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The aim of Evidence-based medicine (EBM) is the unbiased and systematic identification and synthesis of valid scientific data. These best-evidence data may then be used for clinical decision-making. The systematic review is the most important tool of EBM and gives a specific answer to a specific question. ⋯ They treat complications and risks related to anaesthesia, postoperative and labour analgesia, nausea and vomiting, regional anaesthesia, blood transfusion and fluids replacement, and resuscitation. The majority of these systematic reviews are of good quality. In the specific settings of perioperative medicine the number of systematic reviews has become so important that recommendations for evidenced-based strategies of prevention and therapy can be formulated.
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Perioperative cardiac morbidity is one of the main challenges to the anaesthesiologist. Because of demographic changes and the increased prevalence of coronary artery disease (CAD) in elderly patients, the number of those at risk is increasing. Special attention has to be paid to patients bearing an increased risk where CAD has not been proven preoperatively because they represent the majority. ⋯ The usefulness of alpha-2-blockers is not equally well-proven so far. Prevention of perioperative hypothermia can reduce cardiac risk. In addition, there is increasing evidence that thoracic epidural anaesthesia decreases cardiovascular morbidity and mortality.
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Recognized local and systemic complications of retrobulbar anaesthesia (RA) are well known. The purpose of this study was to determine which clinical signs predict the success of the RA technique. ⋯ The results of this study demonstrated that prognostic factors such as defined existing clinical signs, are early predictors of the success of the Atkinson RA.