British journal of anaesthesia
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Randomized Controlled Trial Comparative Study
High-dose steroids in high pain responders undergoing total knee arthroplasty: a randomised double-blind trial.
Total knee arthroplasty (TKA) is associated with moderate-to-severe postoperative pain despite multimodal opioid-sparing analgesia. Pain catastrophising or preoperative opioid therapy is associated with increased postoperative pain. Preoperative glucocorticoid improves pain after TKA, but dose-finding studies and benefit in high pain responders are lacking. ⋯ NCT03763734.
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Multicenter Study
Epidemiology of suspected life-threatening perioperative anaphylaxis: a cross-sectional multicentre study in China.
Perioperative anaphylaxis is relatively rare but can be life-threatening. The incidence in China is unknown and may differ from other global geographic regions. This study was therefore designed to understand the incidence of perioperative anaphylaxis in China. ⋯ ChiCTR1900025956.
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Comparative Study Observational Study
Determining optimal positive end-expiratory pressure and tidal volume in children by intratidal compliance: a prospective observational study.
Limited data exist regarding optimal intraoperative ventilation strategies for the paediatric population. This study aimed to determine the optimal combination of PEEP and tidal volume (VT) based on intratidal compliance profiles in healthy young children undergoing general anaesthesia. ⋯ NCT04633720.
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Randomized Controlled Trial Comparative Study
Patient-maintained versus anaesthetist-controlled propofol sedation during elective primary lower-limb arthroplasty performed under spinal anaesthesia: a randomised controlled trial.
Patient-maintained propofol TCI sedation (PMPS) allows patients to titrate their own target-controlled infusion (TCI) delivery of propofol sedation using a handheld button. The aim of this RCT was to compare PMPS with anaesthetist-controlled propofol TCI sedation (ACPS) in patients undergoing elective primary lower-limb arthroplasty surgery under spinal anaesthesia. ⋯ ISRCTN29129799.
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Editorial Comment
Epidemiology of perioperative anaphylaxis in the United States: new insights but more to learn and do.
Gonzalez-Estrada and colleagues report an estimated risk of severe or fatal perioperative anaphylaxis of one in 6,825 procedures during the period 2005-2014. This is slightly higher than that reported previously in France and England. Several predictors of near-fatal and fatal reactions are identified, such as increased age, cancer, and congestive cardiac failure.