British journal of anaesthesia
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Postoperative nausea and vomiting (PONV) is common and of concern to patients and clinicians. The effect of PONV can range from trivial and transient to major clinical importance, and it is unclear which of its characteristics lead to discomfort and distress. ⋯ The PONV Intensity Scale is a valid, reliable, and responsive measure of clinically important PONV.
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Randomized Controlled Trial
Effect of desflurane at less than 1 MAC on QT interval prolongation induced by tracheal intubation.
Desflurane at more than 1 minimum alveolar concentration (MAC) has been shown to prolong the QT interval, but it is unclear whether this is the case at lower concentrations. The aim of this study was to determine whether desflurane concentrations of <1 MAC affect tracheal intubation-induced prolongation of the QT interval. ⋯ The administration of desflurane at an inspiratory concentration of 1 MAC during manually controlled ventilation after anaesthesia induction with propofol did not affect tracheal intubation-induced QTc prolongation.
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The safety of epidural anaesthesia in patients at risk for right ventricular pressure overload remains controversial. We compared the haemodynamic effects of vascular and cardiac autonomic nerve block, induced by selective lumbar (LEA) and high thoracic epidural anaesthesia (TEA), respectively, in an animal model subjected to controlled acute right ventricular pressure overload. ⋯ In contrast to LEA, TEA reduced the haemodynamic tolerance to PA balloon occlusion by inhibiting the right ventricular positive inotropic response to acute pressure overload.
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The aim of this study was to assess the preventative effect of ketamine on the exaggerated postoperative pain observed in sufentanil-treated mice and its ability to improve the analgesic effectiveness of morphine during the postoperative period in an orthopaedic model of pain. ⋯ Our results suggest that pre-emptive use of ketamine is useful in orthopaedic surgery in this mice model to diminish short- and long-term hyperalgesia, but also to improve morphine effectiveness leading to a better mobilization and more rapid rehabilitation.
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In regional anaesthesia, there is a risk of direct nerve injury. The purpose of this study was to determine whether the diameter of the applied needle is associated with the magnitude of nerve injury after needle nerve perforation. ⋯ The severity of nerve injury after needle nerve perforation was related to the diameter of the applied cannula. However, no such difference exists for regional inflammation. Functional consequences of these findings need to be determined. Currently, small-diameter cannulae may be advisable for peripheral nerve blocks to minimize the risk of nerve injury in the case of nerve perforation.