Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2012
The effect of addition of pregabalin and s-ketamine to local infiltration analgesia on the knee function outcome after total knee arthroplasty.
Pain reduction is important for early mobilization after total knee arthroplasy. Recent studies show that local infiltration analgesia and addition of anti-hyperalgesic drugs (pregabalin and s-ketamine) may improve postoperative analgesia and mobilization. ⋯ A pilot study showed that patients achieved knee flexion of 88.5 degrees (SD 9.6) already on the second postoperative day. The side effects were mild and mostly self-limiting.
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Acta Anaesthesiol Belg · Jan 2012
Case ReportsRefractory hypercapnia: a simplified technique for extracorporeal CO2 removal (ECCO2R) in the presence of therapeutic limitations.
Refractory hypercapnia with severe acidosis appeared in a 67-year-old man who presented with lung fibrosis and a left pneumothorax as delayed complications of bleomycin chemotherapy for advanced grade lymphoma. Due to failure of noninvasive ventilation using a high-flow nasal cannula oxygen system, the patient was mechanically ventilated with two ventilators at different settings, after intubation with a double-lumen tube. ⋯ To remove some amount of carbon dioxide, we used a simplified method based on a veno-venous hemofiltration circuit coupled to a paediatric oxygenator and an air/oxygen blender. The efficacy on carbon dioxide removal was modest, with a percentage of CO2 total extraction ranging from 10.5 to 20.4%, but the system was immediately available, well tolerated and not very expensive.
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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
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
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.