BMC anesthesiology
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Randomized Controlled Trial Comparative Study
Comparison of sciatic nerve block quality achieved using the anterior and posterior approaches: a randomised trial.
The co-administration of sciatic and femoral nerve blocks can provide anaesthesia and analgesia in patients undergoing lower extremity surgeries. Several approaches to achieve sciatic nerve block have been described, including anterior and posterior approaches. ⋯ Anterior and posterior approaches can be used to achieve sciatic nerve block in patients undergoing surgery for malleolar fractures. However, better anaesthesia and pain control results can be obtained if analgesia is administered preoperatively in patients with a posterior approach block and after the start of the operation in patients with an anterior approach block.
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Tracheostomy is a standard procedure in critically ill patients requiring mechanical ventilation or airway protection for extended periods. The main cause of death is haemorrhage, most commonly owing to a trachea-to-innominate artery fistula, usually requiring surgical treatment. ⋯ The use of peri-procedural ultrasound examination of the neck can reduce the risk of complications related to vessel anatomical variants. When the tracheostomy is complicated by bleeding, the procedure should be stopped in order to diagnose the vascular iatrogenic injury and to evaluate the best therapeutic approach by a multidisciplinary team.
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Randomized Controlled Trial Comparative Study
The influence of dexmedetomidine and propofol on circulating cytokine levels in healthy subjects.
Surgery and diseases modify inflammatory responses and the immune system. Anesthetic agents also have effects on the human immune system but the responses they induce may be altered or masked by the surgical procedures or underlying illnesses. The aim of this study was to assess how single-drug dexmedetomidine and propofol anesthesia without any surgical intervention alter acute immunological biomarkers in healthy subjects. ⋯ Dexmedetomidine seemed to have an immunosuppressive effect on the immune system whereas propofol seemed to induce mixed pro- and anti-inflammatory effects on the immune system. The choice of anesthetic agent could be relevant when treating patients with compromised immunological defense mechanisms.
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Comparative Study Observational Study
Investigation of the accuracy of a noninvasive continuous blood pressure device in different age groups and its ability in detecting hypertension and hypotension: an observational study.
CNAP monitor is a continuous and noninvasive blood pressure (BP) measurement device that can be used in intraoperative monitoring. But whether its accuracy changes with age and its detectability of hypertension and hypotension are still unclear. This study was to investigate the agreement of CNAP and invasive arterial pressure (IAP) in different age groups, and the ability of CNAP to detect hypertension and hypotension. ⋯ CNAP showed acceptable agreement with IAP in MBP for all age groups, but reduced agreement with IAP in SBP and DBP, especially for relatively old patients. Ability of CNAP to detect hypertension and hypotension episodes was weaker than IAP. Therefore, CNAP monitor is suitable for young patients and hemodynamically stable surgery, but may not be recommended for old patients with arteriosclerosis and diabetes or surgeries expecting to have fluctuating blood pressure.
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Randomized Controlled Trial Comparative Study
A randomized controlled trial on analgesic effect of repeated Quadratus Lumborum block versus continuous epidural analgesia following laparoscopic nephrectomy.
Epidural analgesia as the effective pain management for abdominal surgery has side effects such as paresthesia, hypotension, hematomas, and impaired motoric of lower limbs. The quadratus lumborum block (QLB) has potential as an abdominal truncal block, however, its analgesic efficacy has never been compared to epidural analgesia on laparoscopic nephrectomy. This prospective randomized controlled study compared the effectiveness of QLB with the epidural analgesia technique in relieving postoperative pain following transperitoneal laparoscopic nephrectomy. ⋯ The repeated QLB had a similar 24-h cumulative morphine requirement, comparable postoperative pain scores and sensory blockade, higher postoperative MAP, a similar degree of motoric block, no difference in the incidence of PONV and paresthesia, and shorter urinary catheter usage, compared to the continuous epidural analgesia following transperitoneal laparoscopic nephrectomy.