British journal of anaesthesia
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Multicenter Study
Variability in practice and factors predictive of total crystalloid administration during abdominal surgery: retrospective two-centre analysis.
Variation in clinical practice in the perioperative environment and intensive care unit is a major challenge facing modern medicine. The objective of the present study was to analyse intraoperative crystalloid administration practices at two academic medical centres in the USA. ⋯ Wide variability in crystalloid administration was observed both within and between individual anaesthesia providers, which might contribute to variability in surgical outcomes.
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The prevalence of use of the World Health Organization surgical checklist is unknown. The clinical effectiveness of this intervention in improving postoperative outcomes is debated. ⋯ The European Surgical Outcomes Study is registered with ClinicalTrials.gov, number NCT01203605.
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Plethysmographic measurement of haemoglobin concentration ([Formula: see text]), pleth variability index (PVI), and perfusion index (PI) with the Radical-7 apparatus is growing in popularity. Previous studies have indicated that [Formula: see text] has poor precision, particularly when PI is low. We wanted to study the effects of a sympathetic block on these measurements. ⋯ Brachial plexus block significantly altered [Formula: see text], PVI, and PI, which indicates that regional nervous control of the arm greatly affects plethysmographic measurements obtained by the Radical-7. After the brachial plexus block, [Formula: see text] increased and PVI decreased.
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Metastatic recurrence of ovarian cancer is the foremost cause of postoperative mortality. With recent research indicating that inhalation of anaesthetics may influence cancer cell behaviour, this study investigated the effects of isoflurane on the expression of tumorigenic markers and proliferative capacity in ovarian cancer cells. ⋯ Our data indicate that isoflurane increases the malignant potential of ovarian cancer cells through the up-regulation of markers associated with the cell cycle, proliferation, and angiogenesis. This study warrants further investigations.