Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2012
Randomized Controlled TrialA randomized, double-blind, controlled trial on non-opioid analgesics and opioid consumption for postoperative pain relief after laparoscopic cholecystectomy.
Following laparoscopic cholecystectomy, an effective post-operative pain control is necessary, at least during the first 24 hours. We present a randomized, double-blind trial on the effect of the combined use of intravenous parecoxib, and metamizol or paracetamol on piritramide consumption using a patient-controlled analgesia (PCA) pump in patients recovering from laparoscopic cholecystectomy. ⋯ The efficacy of tested additive medications on piritramide consumption and pain relief is weak and there is no clear-cut difference between the non-opioid drugs used.
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Acta Anaesthesiol Belg · Jan 2012
Randomized Controlled TrialOptimal wrist angulation shortens time needed for radial artery catheterization: a prospective, randomized, and blinded study.
Optimal wrist position is essential for successful catheterization of the radial artery. We planned to study the success rate of radial artery catheterization at various degrees of wrist extension angulations. ⋯ We conclude that a wrist extension of 450 appears to be the optimal wrist joint extension for a successful radial artery cannula insertion.
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Acta Anaesthesiol Belg · Jan 2012
Reversal of rocuronium-induced neuromuscular block with sugammadex in heart failure patients: a prospective observational study.
The aim of this study was to assess the hemodynamic stability and efficacy of 2 mg/kg sugammadex in reversing rocuronium-induced neuromuscular block in patients with heart failure. Twelve patients who had an ejection fraction < or = 25% and who were undergoing general anesthesia for cardiac resynchronization therapy, an automated implantable cardioverter-defibrillator, or battery replacement of the device were included. Neuromuscular function was monitored by acceleromyography of the adductor pollicis muscle. ⋯ No sugammadex-related adverse events were reported. Sugammadex can adequately restore neuromuscular function in heart failure patients under hemodynamically stable conditions. However, longer reversal times are required than previously observed in healthy, young patients.
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Acta Anaesthesiol Belg · Jan 2012
ReviewSickle cell anaemia and the consequences on the anaesthetic management of cardiac surgery.
A review of the available literature on genetics and pathophysiology of Sickle Cell Anaemia was performed with special emphasis on the intraoperative management during cardiac surgery. Hypoxia, acidosis and hypothermia have been identified as independent sickling provoking factors. ⋯ Additionally, we bundled and reviewed the published expertise in the management of cardiopulmonary bypass and the necessity of hypothermia during cardiac surgery in Sickle Cell patients. Our conclusion is that the available data in case reports and case series on cardiac surgery in case of Sickle Cell Anaemia suggest a necessary preoperative or on bypass blood transfusion to guarantee an uncomplicated course of cardiopulmonary bypass and hypothermia.
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Acta Anaesthesiol Belg · Jan 2012
ReviewSupraclavicular brachial plexus blocks: review and current practice.
This article reviews the possible revival of the supraclavicular brachial plexus blockade due to the use of ultrasound guidance. The brachial plexus is a complex network of nerves, extending from the neck to the axilla, which supplies motor and sensory fibers to the upper extremity. Understanding the complexities of the formation and structure of the brachial plexus remains a cornerstone for effective regional anaesthesia. ⋯ However, because of the proximity of the pleura, most anaesthesiologists have been reluctant to perform this supraclavicular approach. The introduction of ultrasound guidance techniques not only reduces the possible risk of pneumothorax but also allows a faster onset time of the block with a reduction of the local anaesthetic dose. This makes the supraclavicular approach a valuable alternative to the axillary, interscalene and infraclavicular approach for upper limb surgery.