BMC anesthesiology
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Case Reports
Potential side effect of propofol and sevoflurane for anesthesia of anti-NMDA-R encephalitis.
Many anesthetic drugs interact with the NMDA receptor and may therefore alter the clinical presentation of anti-NMDA-R encephalitis. ⋯ In patients with anti-NMDA-R encephalitis, anesthesia using benzodiazepines, opiates and curares, which fail to interfere with the NMDA pathway, should be preferred.
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The pattern of opioid use after skeletal trauma is a neglected topic in pain medicine. The purpose of this study was to analyse the long-term prescriptions of potent opioids among patients with tibial shaft fractures. ⋯ We did not see any signs in registry-data of major dose escalations over time in patients on potent opioids after tibial shaft fractures.
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Early aggressive therapy can reduce the mortality associated with severe sepsis but this relies on prompt recognition, which is hindered by variation among published severity criteria. Our aim was to test the performance of different severity scores in predicting mortality among a cohort of hospital inpatients with sepsis. ⋯ The CURB65 pneumonia severity score outperformed five other severity scores in predicting risk of death among a cohort of hospital inpatients with sepsis. The utility of the CURB65 score for risk-stratifying patients with sepsis in clinical practice will depend on replicating these findings in a validation cohort including patients with sepsis on admission to hospital.
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Randomized Controlled Trial Comparative Study
Intubating conditions and side effects of propofol, remifentanil and sevoflurane compared with propofol, remifentanil and rocuronium: a randomised, prospective, clinical trial.
In 83 patients researchers compared intubation with propofol 1.5 mg/kg, remifentanil 0.30 μg/kg/min & sevoflurane 1.0 MAC to intubation with the same propofol & remifentanil dose, along with rocuronium 0.45 mg/kg.
Acceptable intubating conditions were 18% more frequent in the muscle relaxant group than in those receiving propofol/remi/sevo.
Incidence of laryngeal injury, hoarseness and sore throat was similar between the two groups - which is different to the result from an earlier, larger study of intubation without relaxant: Comparison of two induction regimens using or not using muscle relaxant: impact on postoperative upper airway discomfort.
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Randomized Controlled Trial Multicenter Study Comparative Study
Rocuronium blockade reversal with sugammadex vs. neostigmine: randomized study in Chinese and Caucasian subjects.
This study compared efficacy and safety of the selective relaxant binding agent sugammadex (2 mg/kg) with neostigmine (50 μg/kg) for neuromuscular blockade (NMB) reversal in Chinese and Caucasian subjects. ⋯ Both Chinese and Caucasian subjects recovered from NMB significantly faster after sugammadex 2 mg/kg vs neostigmine 50 μg/kg, with a ~5.7 times (p < 0.0001) faster recovery with sugammadex vs neostigmine in Chinese subjects. Sugammadex was generally well tolerated.