Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2013
Randomized Controlled TrialCombination of remifentanil with isoflurane or propofol: effect on the surgical stress response.
Hormonal and metabolic changes following surgery are markers of the stress response to surgery. We compared hemodynamic parameters and stress response markers (glucose, cortisol, and C-reactive protein) in two groups of patients receiving either propofol or isoflurane combined with remifentanil for maintenance of anesthesia. ⋯ An anesthetic regimen combining propofol and remifentanil attenuates two indicators of the stress response more efficiently than a isoflurane - remifentanil combination.
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Acta Anaesthesiol Belg · Jan 2013
ReviewA review of the interest of sugammadex for deep neuromuscular blockade management in Belgium.
Oro-tracheal intubation and selected surgical conditions are facilitated by a deep neuromuscular block (NMB), but patient's security can be jeopardized by its residual effects at the time of tracheal extubation. Although neostigmine remains the reference reversal agent in many situations, the limitations of its efficacy must be well understood (ceiling effect, delay of action, side effects). It is best administered after re-emergence of the 3rd or 4th train-of-four (TOF) response. ⋯ In Belgium, the use of sugammadex and its reimbursement depend on specific conditions. The excellent clinical tolerance of sugammadex benefits to patients at risk of developing complications related to residual NMB or to the undesirable effects of neostigmine. In all cases, neuromuscular transmission monitoring is the key to adequate NMB management.
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Acta Anaesthesiol Belg · Jan 2013
Comparative StudyFirst experience of the use of the C-MAC PM videolaryngoscope in a clinical setting by anesthetic nurses: a comparison with anesthetists.
The Storz C-MAC videolaryngoscope has been found to facilitate endotracheal intubation and to be easy to use by novice users. However, it has never been studied in those who will probably use it most, anesthetists and anesthetic nurses. The aim of the present study was to identify the number of attempts needed before the participants were able to intubate 2 consecutive patients within 30 seconds. ⋯ This is the first clinical study assessing the use of the C-MAC videolaryngoscope by inexperienced anesthetists and anesthetic nurses indicating that it is easy to learn and to use in their hands.
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Acta Anaesthesiol Belg · Jan 2013
Case ReportsCan low dose spinal anesthesia combined with ultrasound guided bilateral ilioinguinal-iliohypogastric nerve blocks avoid use of additional epidural catheter in high risk obstetric cases? Our experience from two cases.
Critical obstetric cases associated with cardiac pathology may pose real challenge for anaesthesiologist during Caesarean section. Meticulous perioperative care and suitable selection of anaesthesia technique are the key to successful outcome. Single shot spinal anaesthesia is not used any more because of serious haemodynamic consequence. ⋯ However, institution of such complex technique may require time which may not be feasible in emergency situations. Use of bilateral ilioinguinal-iliohypogastric nerve block along with low dose spinal anaesthesia may obviate the need of additional epidural catheter in such complicated cases. We hereby present our experience from two cases.