Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2006
Randomized Controlled Trial Multicenter Study Comparative StudyRopivacaine versus bupivacaine 0.125% with fentanyl 1 microg/ml for epidural labour analgesia: is daily practice more important than pharmaceutical choice?
Ropivacaine might be superior to bupivcaine for epidural labour analgesia because it appears to induce less lower extremity motor blockade. The clinical relevance of this difference is not yet clear. ⋯ Institutional clinical practice can be significantly different. Pharmacological differences between bupivacaine and ropivacaine at 0.125% with 1 microg/ml fentanyl seem to be less important than differences between institutions in terms of clinical practice.
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Acta Anaesthesiol Belg · Jan 2006
Randomized Controlled Trial Comparative StudyPretreatment with magnesium sulphate is associated with less succinylcholine-induced fasciculation and subsequent tracheal intubation-induced hemodynamic changes than precurarization with vecuronium during rapid sequence induction.
Although it has side effects, succinylcholine is still widely used in rapid sequence induction. The aim of the present study is to evaluate the effects of pretreat ment with magnesium and precurarization of vecuroni um on succinylcholine-induced fasciculation and subse quent tracheal intubation-induced hemodynamic changes during rapid sequence induction. ⋯ Fasciculation scores and mean percent changes of heart rate, systolic blood pressure and rate pressure product between baseline and after induction were significantly lower in group M than those in group C and group V. Pretreatment with magnesium is more effective to limit succinylcholine-induced fasciculation and subsequent tracheal intubation-induced hemody namic changes in rapid sequence induction compared with vecuronium pretreatment, although magnesium does not prevent the elevation of serum potassium con centration after induction.
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Acta Anaesthesiol Belg · Jan 2006
Multicenter Study Clinical TrialEmergency reversal of oral anticoagulation through PPSB-SD: the fastest procedure in Belgium.
To corroborate results obtained in The Netherlands with PPSB-SD, showing a safe acute reversal of anticoagulation within 15 minutes of administration. ⋯ PPSB-SD can safely be used for the rapid reversal of anticoagulation as needed in emergency situations.
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Acta Anaesthesiol Belg · Jan 2006
Randomized Controlled TrialThe effect of analgesic state on implicit learning during propofol anesthesia in volunteers.
Noxious stimulation may enhance implicit learning during general anesthesia. It is unknown, however, whether analgesic state can influence this memory processing. Twenty healthy adult volunteers were enrolled our prospective, double-blinded, controlled experiments. ⋯ During phase A, the word stem completion test revealed implicit learning for played words. In contrast, no implicit memory was detected during phase B. This study indicates that analgesia with remifentanil TCI (titrated to loss of movement on noxious stimulation), prevented implicit memory processing during stable propofol anesthesia in healthy adult volunteers.
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Potent opioids are excellent painkillers but their use is hampered by side-effects such as nausea, vomiting, bowel dysfunction, urinary retention, pruritus, sedation and respiratory depression. Co-analgesics are often combined with opioids to reduce the prevalence of these unwanted effects while maintaining or even improve the quality of analgesia. ⋯ In contrast, intravenous lidocaine and corticosteroids not only produce an opioid-sparing but also a significant reduction in the occurrence of postoperative ileus and nausea and vomiting. It remains unclear whether the perioperative use gabapentin, ketamine and corticosteroids has an effect on the development of postsurgical chronic pain states.