British journal of anaesthesia
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Randomized Controlled Trial
Influence of variations in systemic blood flow and pressure on cerebral and systemic oxygen saturation in cardiopulmonary bypass patients.
Although both pressure and flow are considered important determinants of regional organ perfusion, the relative importance of each is less established. The aim of the present study was to evaluate the impact of variations in flow, pressure, or both on cerebral and whole-body oxygen saturation. ⋯ In the present elective cardiac surgery population, Sc(O₂) and Sv(O₂) were significantly lower with lower flow, regardless of systemic arterial pressure. Moreover, phenylephrine administration was associated with a reduced cerebral and systemic oxygen saturation.
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Multicenter Study Clinical Trial
Performance of a new pulse contour method for continuous cardiac output monitoring: validation in critically ill patients.
A new calibrated pulse wave analysis method (VolumeView™/EV1000™, Edwards Lifesciences, Irvine, CA, USA) has been developed to continuously monitor cardiac output (CO). The aim of this study was to compare the performance of the VolumeView method, and of the PiCCO2™ pulse contour method (Pulsion Medical Systems, Munich, Germany), with reference transpulmonary thermodilution (TPTD) CO measurements. ⋯ The performance of the new VolumeView™-CCO method is as reliable as the PiCCO2™-CCO pulse wave analysis in critically ill patients. However, an improved precision was observed with the VolumeView™ technique. CLINICALTRIALS.GOV IDENTIFIER: NCT01405040.
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Randomized Controlled Trial Comparative Study
Postoperative analgesic effect of intravenous (i.v.) clonidine compared with clonidine administration in wound infiltration for open cholecystectomy.
This randomized double-blind study was designed to compare the postoperative analgesic effect of clonidine administered intravenously or in wound infiltration with bupivacaine. ⋯ Clonidine 3 μg kg(-1) provided effective postoperative analgesia and reduced morphine requirement when administered intravenously or in wound infiltration with bupivacaine. However, the incidence of complications was less with wound infiltration. CLINICAL TRIAL REGISTRY OF INDIA: (www.ctri.nic.in/), registration number CTRI/2012/12/003258.
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Randomized Controlled Trial
Effect of ketamine as an adjunct to intravenous patient-controlled analgesia, in patients at high risk of postoperative nausea and vomiting undergoing lumbar spinal surgery.
We evaluated the effect of ketamine as an adjunct to a fentanyl-based i.v. patient-controlled analgesia (IV-PCA) on postoperative nausea and vomiting (PONV) in patients at high risk of PONV undergoing lumbar spinal surgery. ⋯ Ketamine did not reduce the incidence of PONV and exerted a negative influence on the severity of nausea. It was, however, able to reduce postoperative fentanyl consumption in patients at high-risk of PONV.