British journal of anaesthesia
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Multiple studies have shown that cerebral tissue oxygen saturation (Sct(O(2))) is decreased after phenylephrine treatment. We hypothesized that the negative impact of phenylephrine administration on Sct(O(2)) is affected by arterial blood carbon dioxide partial pressure (Pa(CO(2))) because CO(2) is a powerful modulator of cerebrovascular tone. ⋯ The negative impact of phenylephrine treatment on Sct(O(2)) and CBV is intensified during hypocapnia while blunted during hypercapnia.
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Comparative Study
Accuracy of respiratory rate monitoring using a non-invasive acoustic method after general anaesthesia.
Respiratory rate should be monitored continuously in the post-anaesthesia care unit (PACU) to avoid any delay in the detection of respiratory depression. Capnometry is the standard of care but in extubated patients requires a nasal cannula or a face mask that may be poorly tolerated or can be dislodged, leading to errors in data acquisition and false alarms. The value of a new non-invasive acoustic monitor in this setting has not been fully investigated. ⋯ In extubated patients, continuous assessment of respiration rate with an acoustic monitor correlated well with capnometry.
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Draw-over anaesthesia is widely used throughout the developing world, in disaster areas and in military anaesthesia when the supply of pressurized oxygen is unreliable. To date, no draw-over vaporizer has been able to deliver sufficient concentrations of sevoflurane for use in inhalation induction of anaesthesia. A laboratory study to assess the performance of a new vaporizer (DDV2) to deliver sevoflurane in a wide range of situations is described. ⋯ The modifications to the DDV2 allow stable concentrations of sevoflurane to be delivered in draw-over and continuous flow modes over a range of temperatures. With continuous flow, concentrations of sevoflurane sufficient for induction of anaesthesia can be achieved.
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The role of epinephrine combined with lipid emulsion in rescuing cardiovascular collapse induced by local anaesthetic overdose remains unclear. The objective of this study was to explore the effect of epinephrine on delayed lipid-based treatment for bupivacaine-induced cardiac arrest in rats. ⋯ Late intervention with epinephrine plus lipid emulsion contributed to sustained improvement in haemodynamic profile, but failed to alleviate deterioration of hypoxaemia and acidaemia in rats.