British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Reducing allogeneic transfusion in cardiac surgery: a randomized double-blind placebo-controlled trial of antifibrinolytic therapies used in addition to intra-operative cell salvage.
The transfusion of allogeneic red blood cells and allogeneic coagulation products is associated with risk to the patient and the depletion of an increasingly scarce resource. This prospective, randomized, double-blind, placebo-controlled trial investigated practices to avoid transfusion in patients undergoing first-time cardiac surgery. ⋯ When used in addition to intra-operative cell salvage, aprotinin is the most efficacious pharmacological therapy for reducing patient exposure to any allogeneic transfusion during first-time cardiac surgery.
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This study prospectively determined the haemodynamic changes in the lower limb venous circulation during and shortly after elective abdominal surgery, performed under general anaesthesia. ⋯ A significant decrease in the volume flow, mean and minimum velocities was noted during and immediately after elective total abdominal hysterectomy under general anaesthesia in ASA I and II patients. Flow changes in early recovery mirrored or enhanced those noted intraoperatively. Despite venous flow attenuation, haemodynamic readjustments produced a significant and progressive enhancement of venous flow pulsatility during the course of the procedure.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative effects of ketamine on Bispectral Index and spectral entropy of the electroencephalogram under sevoflurane anaesthesia.
The Bispectral Index (BIS) and spectral entropy of the electroencephalogram can be used to assess the depth of hypnosis. Ketamine is known to increase BIS in anaesthetized patients and may confound that index as a guide to steer administration of hypnotics. We compared the effects of ketamine on BIS, response entropy (RE) and state entropy (SE) during surgery under sevoflurane anaesthesia. ⋯ Ketamine administered under sevoflurane anaesthesia causes a significant increase in BIS, RE and SE without modification of the RE-SE gradient. This increase is paradoxical in that it is associated with a deepening level of hypnosis.
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Randomized Controlled Trial Clinical Trial
The preoperative administration of ketoprofen improves analgesia after laparoscopic cholecystectomy in comparison with propacetamol or postoperative ketoprofen.
Non-opioid analgesics, paracetamol and non-steroid anti-inflammatory drugs (NSAIDs) are proposed for pain relief after laparoscopy. We compared perioperative propacetamol (P) and ketoprofen (K) to provide analgesia after laparoscopic cholecystectomy. ⋯ Preoperative administration of ketoprofen improves postoperative analgesia after laparoscopic cholecystectomy compared with its postoperative administration and pre- and postoperative propacetamol.