British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Cardiovascular changes with the laryngeal mask airway in cardiac anaesthesia.
The laryngeal mask airway (LMA) causes fewer haemodynamic changes, particularly in mean arterial pressure (MAP) and heart rate (HR), than tracheal intubation using either laryngoscopy or the intubating LMA. There are no data for patients with coronary artery disease. ⋯ The LMA allows airway management without hypertension and tachycardia and should be considered when anaesthetizing patients with coronary disease.
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Randomized Controlled Trial Clinical Trial
Drug patient information leaflets in anaesthesia: effect on anxiety and patient satisfaction.
Patient information leaflets are produced for all new drugs, including anaesthetic drugs that are licensed solely for physician administration. The effect of this information on patients' satisfaction and anxiety has not been investigated previously. ⋯ A minority of patients (up to 36%) wish to receive detailed anaesthetic drug information before anaesthesia. Manufacturers' drug patient information leaflets do not alter preoperative anxiety and may be safely issued to patients requesting such information.
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Reduction of heat losses from the skin by thermal insulation is used to avoid perioperative hypothermia. However, there is little information about the physical properties of various insulating materials used in the operating room. ⋯ There are relevant differences between various insulating materials. The best commercially available material designed for use in the operating room (Barkey thermcare 1) can reduce heat loss from the covered area by 45% when used in two layers. Given the range of insulating materials available for outdoor activities, significant improvement in insulation of patients in the operating room is both possible and desirable.
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Mid-line thoracotomy is a standard approach for cardiac surgery. However, little is known how this surgical approach affects the interaction between the circulation and mechanical ventilation. We studied how mid-line thoracotomy affects cardiac filling volumes and cardiovascular haemodynamics, particularly variations in stroke volume and pulse pressure caused by mechanical ventilation. ⋯ Thoracotomy increases cardiac filling and preload. Further, thoracotomy reduces the effect of mechanical ventilation on left ventricular stroke volume. However, also under open chest conditions, SVV and PPV are preload-dependent.