Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2008
Randomized Controlled Trial Multicenter StudyDoes the use of a volatile anesthetic regimen attenuate the incidence of cardiac events after vascular surgery?
To compare the effects of a volatile anesthetic to a non-volatile anesthetic regimen on the incidence of postoperative cardiac events, including the postoperative elevation of troponin I values after arterial vascular surgery in high risk patients. ⋯ The results of this hypothesis-generating study suggest that potential beneficial effects on extent of postoperative myocardial damage in high risk patients undergoing arterial surgery will probably be more apparent in abdominal aortic surgery than in peripheral vascular surgery. Further sufficiently powered studies using a standardized protocol should now be performed to definitively address this question.
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Acta Anaesthesiol Belg · Jan 2008
Randomized Controlled Trial Comparative StudyMethylprednisolone vs. dexamethasone in the prevention of postoperative nausea and vomiting: a prospective, randomised, double-blind, placebo-controlled trial.
Dexamethasone and methylprednisolone have been proven effective in the prevention of nausea after chemotherapy. Dexamethasone has been proven effective in the prophylaxis of late PONV. Literature about methylprednisolone in PONV prophylaxis is rare. ⋯ There was a beneficial clinical effect of dexamethasone in this population, although not significant. A possible explanation lies in the fact that monotherapy is mostly insufficient in a population at risk like ours. This study confirms that steroids are mostly effective in the prevention of late PONV, less effective in early PONV.
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Acta Anaesthesiol Belg · Jan 2008
Randomized Controlled TrialPrevention of postoperative hypotension following spinal anesthesia for TURP: a double-blind randomized controlled trial comparing ephedrine with placebo.
Spinal hypotension (SH) is a common side effect of spinal anesthesia and may also occur after the surgical procedure. In this double-blinded, placebo-controlled, randomised clinical trial fifty patients undergoing transurethral prostatectomy under spinal anesthesia received 10 mg of ephedrine IV before being transferred from the operating table into their bed after the procedure, whereas fifty controls received saline IV. The number of per- and postoperative hypotensive episodes and vasopressor use, time delay between the administration of the study medication and the first hypotensive episode, level of spinal blockade at the start of surgery, pre- and postoperative hemoglobine and sodium concentration, cardiovascular co-morbidity and chronic medication were registered. ⋯ There was no statistically significant relation between age, level of spinal blockade, cardiovascular co-morbidity or biochemical parameters and the risk of developing per- or postoperative hypotension, except for a correlation between preoperative alpha-receptor blocking drugs and peroperative hypotension (p < 0.05). Postoperative hypotension (recorded incidence 31%) was almost as common as peroperative hypotension (recorded incidence 37%) and occurred as late as 190 minutes after the end of surgery. Ephedrine IV at the end of surgery reduced the number of postoperative hypotensive episodes per patient but did not reduce the overall incidence of postoperative SH.
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Acta Anaesthesiol Belg · Jan 2008
Randomized Controlled Trial Comparative StudySpinal anesthesia: comparison of plain ropivacaine, bupivacaine and levobupivacaine for lower abdominal surgery.
This study was performed to compare the anesthetic efficacy and safety of three local anesthetic agents: racemic bupivacaine and its two isomers: ropivacaine and levobupivacaine, in patients undergoing lower abdominal surgery. One hundred-twenty patients, ASA I-III, were randomized to receive an intrathecal injection of one of three local anesthetic solutions. Group A (n = 40) received 3 ml of isobaric bupivacaine 5 mg/ml (15 mg). ⋯ The onset of motor block was significantly faster in the bupivacaine group compared with that in the ropivacaine group and almost the same of that in the levobupivacaine group (P < 0.05). Ropivacaine presented a shorter duration of both motor and sensory block than bupivacaine and levobupivacaine (P < 0.05). Bupivacaine required more often the use of a vasoactive drug (ephedrine) compared to both ropivacaine and levobupivacaine and of a sympathomimetic drug (atropine) compared to the ropivacaine group.
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Acta Anaesthesiol Belg · Jan 2008
Randomized Controlled Trial Comparative StudyLearning Basic Life Support (BLS) with task cards: comparison of four reciprocal learning settings.
Research emphasises the need for instructional methods and tools which can improve BLS performance or reduce instructional time. ⋯ This study demonstrated that implementing role switching and role definition in a reciprocal learning setting with task cards fosters BLS skill retention.