Anaesthesia, critical care & pain medicine
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Anaesth Crit Care Pain Med · Dec 2016
Evaluation of a continuous improvement programme of enhanced recovery after caesarean delivery under neuraxial anaesthesia.
To assess the performance of a multidisciplinary programme for enhanced recovery after caesarean delivery under neuraxial anaesthesia. ⋯ Improved practices in rehabilitation after caesarean can be obtained by setting up a multidisciplinary programme as part of a quality approach.
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Anaesth Crit Care Pain Med · Dec 2016
Continuous interscalene brachial plexus nerve block prolongs unilateral diaphragmatic dysfunction.
Single interscalene blocks (ISB) impair pulmonary function (<24h). We hypothesized that continuous ISBs would prolong pulmonary dysfunction until h48 compared with a single ISB. We compared the time course of spirometric and diaphragmatic dysfunction following single or continuous ISBs. ⋯ Over infusion, continuous ISB did not significantly prolong unilateral phrenic paresis and demonstrated a limited pulmonary impact.
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Anaesth Crit Care Pain Med · Dec 2016
ReviewPrilocaine spinal anesthesia for ambulatory surgery: A review of the available studies.
Transient neurologic symptoms (TNS) led to the abandonment of intrathecal lidocaine. We reviewed the published literature for information about the duration of action and side effects of intrathecal prilocaine, which has been recently reintroduced in Europe. Medline and EMBASE databases were searched for the time period from 1966 to 2015. ⋯ Four cases of TNS in 486 patients were reported in prospective studies, and none in 5000 cases in a retrospective data set. Spinal prilocaine appears to be safe and reliable for day case anesthesia. However, as chloroprocaine has a shorter duration and a lower risk of TNS and urinary retention, the indications for prilocaine remain to be defined.
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Anaesth Crit Care Pain Med · Dec 2016
Observational StudyThe Doppler renal resistive index for early detection of acute kidney injury after hip fracture.
Postoperative acute kidney injury (AKI) is linked to an increase in morbidity and mortality, particularly in elderly populations. This study's aim was to assess the accuracy of the Doppler renal resistive index (RI) in detecting AKI at an early stage after hip fracture surgery. ⋯ The calculation of the RI during the perioperative periods of hip fracture surgery predicts early and effectively the postoperative occurrence of AKI, thus allowing treatment to be anticipated so as to improve patient prognosis.
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Anaesth Crit Care Pain Med · Dec 2016
Randomized Controlled Trial Comparative StudyPostoperative analgesia after caesarean section with transversus abdominis plane block or continuous infiltration wound catheter: A randomized clinical trial. TAP vs. infiltration after caesarean section.
Single shot transversus abdominis plane (TAP) block and continuous local anesthetic infiltration wound catheter (CLAIWC) decreased the morphine consumption after caesarean section. The aim of this study was to compare the analgesic efficacy of CLAIWC and ultrasound-guided TAP block. ⋯ As part of a multimodal analgesic regimen, there is no significant difference between the TAP block and CLAIWC for postoperative analgesia after a caesarean section.