Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2012
GuidelineBelgian recommendations on perioperative maintenance fluid management of surgical pediatric population.
The European recommendations on perioperative maintenance fluids in children have recently been adapted from hypotonic to isotonic electrolyte solutions with lower glucose concentrations. In Belgium, however, the commercially approved solutions do not match with these recommendations and there is neither consensus nor mandate about the composition and volume of perioperative maintenance fluids in children undergoing surgery despite the continuing controversy in literature. This paper highlights the significant challenges and shortcomings while prescribing fluid therapy for pediatric surgical patients in Belgium. It is sensible to the authors to address these issues with national guidance through an organization such as The Belgian Association for Paediatric Anaesthesiology, and to propose Belgian recommendations on perioperative fluid management in surgical children, with the intention of improving the quality of care in this population.
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Acta Anaesthesiol Belg · Jan 2012
Review Meta AnalysisInadvertent epidural injection of drugs for intravenous use. A review.
The frequency of inadvertent injection of drugs in the epidural space is probably underestimated and underreported, but it can cause serious morbidity and possibly mortality. ⋯ Most drugs do not lead to sequelae other than pain during injection or transient neurological complaints. Other drugs may have more deleterious consequences, such as paraplegia. Both the dose of the inadvertent injected drug and the time frame play an important role in the patient's outcome. "Syringe swap", "ampoule error", and epidural/intravenous line confusion due to inaccurate or absent colour coding of epidural catheters were the main sources of error. Preventive strategies, including non Luer-lock epidural injection ports, might increase safety.
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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
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.