British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Effect of dexamethasone on perioperative renal function impairment during cardiac surgery with cardiopulmonary bypass.
In cardiac surgery with cardiopulmonary bypass (CPB), corticosteroids are administered to attenuate the physiological changes caused by the systemic inflammatory response. The effects of corticosteroids on CPB-associated renal damage have not been documented. The purpose of this study was to evaluate the effects of dexamethasone on perioperative renal dysfunction in patients undergoing cardiac surgery with CPB. ⋯ Dexamethasone administration before CPB has no protective effect on perioperative renal dysfunction in low-risk cardiac surgical patients.
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Randomized Controlled Trial Clinical Trial
Role of beta-blockade in anaesthesia and postoperative pain management after hysterectomy.
Perioperative use of beta-blockers has been advocated as a strategy to prevent cardiac sequelae. This study evaluated the influence of perioperative esmolol administration upon anaesthesia and postoperative pain management amongst patients undergoing hysterectomy. ⋯ The results suggest that perioperative esmolol administration during anaesthesia reduces the intraoperative use of inhalation anaesthetic and fentanyl, decreases haemodynamic responses, and reduced morphine consumption for the first 3 postoperative days.
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Randomized Controlled Trial Clinical Trial
Awareness and the EEG power spectrum: analysis of frequencies.
Power spectral analysis is a well-established method for the analysis of EEG signals. Spectral parameters can be used to quantify pharmacological effects of anaesthetics on the brain and the level of sedation. This method, in numerous variations, has been applied to depth of anaesthesia monitoring and has been incorporated into several commercially available EEG monitors. Because of the importance of EEG spectral analysis, we evaluated the performance of each frequency in the power spectrum regarding detection of awareness. ⋯ The best performance for the detection of awareness was achieved by EEG power spectral frequencies from >35 Hz up to 127 Hz. This frequency band may be dominated by muscle activity. The frequency band between 15 and 26 Hz may be of limited value, as reflected by lower rPK values.
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Randomized Controlled Trial Clinical Trial
Fast-tracking (bypassing the PACU) does not reduce nursing workload after ambulatory surgery.
Postoperative day-case patients are usually allowed to recover from anaesthesia in a postanaesthesia care unit (PACU) before transfer back to the day surgical unit (DSU). Bypassing the PACU can decrease recovery time after day surgery. Cost savings may result from a reduced nursing workload associated with the decreased recovery time. This study was designed to evaluate the effects of bypassing the PACU on patient recovery time and nursing workload and costs. ⋯ Bypassing the PACU after these short outpatient procedures significantly decreases recovery time without compromising patient satisfaction. However, the overall nursing workload and the associated cost were not significantly affected.