Acta anaesthesiologica Belgica
-
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.
-
Acta Anaesthesiol Belg · Jan 2012
Randomized Controlled Trial Comparative StudySimilar oropharyngeal leak pressures during anaesthesia with i-gel, LMA-ProSeal and LMA-Supreme Laryngeal Masks.
We test the hypothesis that there are differences in performance among three extra-glottic airway devices during spontaneous breathing anaesthesia. ⋯ The LMA-Supreme is easier and quicker to insert than the LMA-ProSeal and i-gel using a laryngoscope-guided, gastric tube-guided technique and is associated with better anatomical positioning than the i-gel. Oropharyngeal leak pressures are similar among devices.
-
Acta Anaesthesiol Belg · Jan 2012
ReviewOpioids and protection against ischemia-reperfusion injury: from experimental data to potential clinical applications.
Ischemic preconditioning, first demonstrated in animal myocardium, is an intrinsic and ubiquitous mechanism of marked protection against ischemia. Accumulating evidences have established that endogenous opioid peptides and their receptors play an important role in this adaptive phenomenon in the heart and other major organs. ⋯ Recent human studies now raise the possibility to exploit this opioid-induced protection in clinical cardiac ischemia. These remarkable anti-ischemic properties of opioids and their emerging potential for organ protection in perioperative medicine will be reviewed at the light of pertinent results from basic and clinical researches.
-
Acta Anaesthesiol Belg · Jan 2012
Randomized Controlled TrialEndotracheal intubation using videolaryngoscopy causes less cardiovascular response compared to classic direct laryngoscopy, in cardiac patients according a standard hospital protocol.
Previous studies comparing Glidescope and classic direct laryngoscopy did not show an attenuation of CV responses to endotracheal intubation. In the present study, we hypothesize that indirect videolaryngoscopy can attenuate cardiovascular responses to endotracheal intubation. ⋯ Our study shows less hemodynamic responses during endotracheal intubation using indirect videolaryngoscopy compared to classic direct laryngoscopy.
-
Acta Anaesthesiol Belg · Jan 2012
Paracetamol and ketorolac pharmacokinetics and metabolism at delivery and during postpartum.
During pregnancy, changes in renal elimination, body composition and metabolic activity occur. Since these important alterations in physiology also affect drug disposition, pregnancy warrants a focused approach. ⋯ We report on our observations on i.v. paracetamol and ketorolac disposition following cesarean delivery to illustrate the feasibility of such focused studies and the impact of pregnancy on drug disposition. The clinical relevance of these observations are subsequently discussed, and some future research directions are suggested.