British journal of anaesthesia
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Candida species are a common cause of nosocomial bloodstream infection. Such infections commonly affect patients in the intensive care unit (ICU) and carry a high mortality. There are published guidelines for the management of fungal infections, but there are no data on the usual management of invasive Candida infections in UK ICUs. ⋯ Management of fungal infections is relatively consistent among responding units. However, recent developments in the field have not yet been incorporated into standard practice. Adherence to published guidelines could be improved, potentially reducing morbidity and mortality from these common infections.
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Letter Case Reports
Sugammadex administration results in arousal from intravenous anaesthesia: a clinical and electroencephalographic observation.
Chazot et al. describe a 25 yo undergoing a Nissen fundoplication, receiving TCI propofol/remifentanil (targets of 2.3 ug/mL & 4 ng/mL respectively) along with rocuronium. The deep neuromuscular block was reversed with sugammadex 4 mg/kg and the patient awoke within 80 seconds (clinically and BIS > 90) despite TCI targets continuing. No awareness was noted.
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Comparative Study
Anaesthetic technique may affect prognosis for ovarian serous adenocarcinoma: a retrospective analysis.
Animal studies have shown that regional anaesthesia and analgesia may prevent or attenuate the surgical stress response by preserving immune function and result in better long-term outcome. We have tested the hypothesis that patients with ovarian serous adenocarcinoma who had surgery with epidural anaesthesia and analgesia would have better long-term outcome than those who were given general anaesthesia (GA) and i.v. opioid analgesia. ⋯ This retrospective analysis suggests that epidural anaesthesia and analgesia for ovarian serous adenocarcinoma surgery may reduce mortality during the initial years of follow-up.
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Randomized Controlled Trial
Does the prophylactic administration of magnesium sulphate to patients undergoing thoracotomy prevent postoperative supraventricular arrhythmias? A randomized controlled trial.
Supraventricular arrhythmias (SVA) are common after thoracic surgery and are associated with increased morbidity and mortality. This prospective, randomized, double-blind, placebo-controlled trial examined the effects of perioperative magnesium on the development of postoperative SVA. ⋯ Overall, prophylactic magnesium did not reduce the incidence of SVA in patients undergoing thoracotomy. However, it reduced the incidence of SVA in the high-risk cohort of patients undergoing pneumonectomy. (ISRCTN22028180.).