British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Tranexamic acid decreases external blood loss but not hidden blood loss in total knee replacement.
Total knee arthroplasty (TKA) is often carried out using a tourniquet and shed blood is collected in drains. Tranexamic acid decreases the external blood loss. Some blood loss may be concealed, and the overall effect of tranexamic acid on the haemoglobin (Hb) balance is not known. ⋯ Tranexamic acid decreased total blood loss by nearly 30%, drainage volume by approximately 50% and drastically reduced transfusion. However, concealed loss was only marginally influenced by tranexamic acid and was at least as large as the drainage volume.
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Case Reports
Detection of cerebral hypoperfusion with bispectral index during paediatric cardiac surgery.
The bispectral index (BIS) may indicate changes in cerebral activity when the cerebral circulation is affected by acute hypotension. ⋯ Our findings suggest that an acute decrease in BIS during acute hypotension indicates cerebral hypoperfusion, and that cerebral hypoperfusion caused by hypotension may occur frequently during paediatric cardiac surgery.
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Randomized Controlled Trial Clinical Trial
Warming by resistive heating maintains perioperative normothermia as well as forced air heating.
Even mild perioperative hypothermia is associated with several severe adverse effects. Resistive heating has possible advantages compared with other active warming systems because it can heat several fields independently. To assess this new warming system, we measured core temperature in patients during surgery who were warmed with circulating water mattresses, forced air covers or resistive heating covers. ⋯ Resistive heating maintains core body temperature as well as forced air heating and both are better than circulating water. Resistive heating offers the advantage of adjustable heating pods.
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Randomized Controlled Trial Clinical Trial
Relationship between awareness and middle latency auditory evoked responses during surgical anaesthesia.
Some studies support the view that meaningful auditory input can be processed by the brain during apparent surgical anaesthesia. Consequently, patients may be able to remember some information implicitly after anaesthesia as well through a 'dream-like process' (subconscious awareness). The aim of this study was to investigate the presence of subconscious awareness during anaesthesia and to examine its relationship to the mid-latency auditory evoked responses (MLAERs). ⋯ MLAERs may help to predict subconscious cerebral processing of auditory inputs during anaesthesia.
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Little is known about cerebral autoregulation in children. The aim of this study was to examine cerebral autoregulation in children. ⋯ We found no age-related differences in autoregulatory capacity during low-dose sevoflurane anaesthesia. We report no differences in autoregulatory capacity between children and adults.