MedWorm: Anesthesiology

Comparison of the prophylactic anti-emetic efficacy of ramosetron and ondansetron in patients at high-risk for postoperative nausea and vomiting after total knee replacement

Anaesthesia — Sat, 20 Mar 2010 00:00:00 +0100

We compared the prophylactic anti-emetic efficacy of ramosetron, a newly developed 5-HT3 antagonist, and ondansetron in patients at high-risk for postoperative nausea and vomiting after total knee replacement. Eighty-four patients with three risk factors for postoperative nausea and vomiting (female, non-smoking and use of postoperative opioid use (ropivacaine and hydromorphone patient controlled epidural analgesia)) undergoing unilateral total knee replacement were randomly allocated to ramosetron 0.3 mg (n = 42) or ondansetron 4 mg (n = 42) groups. A complete response (no postoperative nausea and vomiting and no rescue anti-emetic) and the incidence of postoperative nausea and vomiting were assessed for 48 h after surgery at 0[ndash]2 h, 2[ndash]6 h, 6[ndash]24 h, and 24[ndash]48 h. More...

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Dr. Mike Roizen To Give Keynote Speech At Annual Meeting For The International Anesthesia Research Society

Pain / Anesthetics News From Medical News Today — Fri, 19 Mar 2010 08:00:00 +0100

The International Anesthesia Research Society (IARS) announces that Dr. Michael Roizen of the Cleveland Clinic Wellness Center will deliver the T.H. Seldon Memorial Lecture, the keynote speech of the 2010 Annual Meeting for the International Anesthesia Research Society, to be held in Honolulu, Hawaii. Dr... (Source: Pain / Anesthetics News From Medical News Today)

Alkermes Announces Initiation Of Multidose Phase 1 Clinical Study Of ALKS 37 For The Treatment Of Opioid-Induced Constipation

Pain / Anesthetics News From Medical News Today — Fri, 19 Mar 2010 08:00:00 +0100

Alkermes, Inc. (NASDAQ: ALKS) announced the initiation of a multidose phase 1 clinical study of ALKS 37, an orally active, peripherally-restricted opioid antagonist with potential to block the effects of opioid agonists on gastrointestinal motility, commonly referred to as opioid-induced constipation (OIC)... (Source: Pain / Anesthetics News From Medical News Today)

Health Highlights: March 18, 2010

MedicineNet Chronic Pain General — Fri, 19 Mar 2010 07:00:00 +0100

Title: Health Highlights: March 18, 2010Category: Health NewsCreated: 3/18/2010 12:10:00 PMLast Editorial Review: 3/19/2010 (Source: MedicineNet Chronic Pain General)

What Is Euthanasia (assisted Suicide)? What Is The Definition Of Assisted Suicide Or Euthanasia?

Pain / Anesthetics News From Medical News Today — Fri, 19 Mar 2010 07:00:00 +0100

Euthanasia, also known as assisted suicide, physician-assisted suicide (dying) , doctor-assisted dying (suicide) , and more loosely termed mercy killing, basically means to take a deliberate action with the express intention of ending a life to relieve intractable (persistent, unstoppable) suffering. Some interpret euthanasia as the practice of ending a life in a painless manner... (Source: Pain / Anesthetics News From Medical News Today)

Cardiac arrest in the left lateral decubitus position and extracorporeal cardiopulmonary resuscitation during neurosurgery: a case report

Journal of Anesthesia — Fri, 19 Mar 2010 06:49:25 +0100

Abstract Cardiopulmonary resuscitation (CPR) in the lateral position during noncardiac surgery has been described in only a few reports in the past. Here, we report a case of cardiac arrest in a 61-year-old man undergoing microvascular decompression surgery for trigeminal neuralgia in the left lateral decubitus position. During the initial 5 min of CPR, chest compression was performed in this position by two rescuers; one from the chest and the other from the back, pushing simultaneously. Because ventricular arrhythmia was refractory to conventional CPR even after placing the patient back to the supine position, extracorporeal life support was introduced in the operating room by using the femoro–femoral approach (right atrio-femoral veno-arterial bypass). This alter...

Awake tracheal intubation using the Sensascope™ in 13 patients with an anticipated difficult airway

Anaesthesia — Fri, 19 Mar 2010 00:00:00 +0100

We present the use of the SensaScope[trade], an S-shaped rigid fibreoptic scope with a flexible distal end, in a series of 13 patients at high risk of, or known to have, a difficult intubation. Patients received conscious sedation with midazolam or fentanyl combined with a remifentanil infusion and topical lidocaine to the oral mucosa and to the trachea via a trans-cricoid injection. Spontaneous ventilation was maintained until confirmation of tracheal intubation. In all cases, tracheal intubation was achieved using the SensaScope. The median (IQR [range]) insertion time (measured from the time the facemask was taken away from the face until an end-expiratory CO2 reading was visible on the monitor) was 58 s (38[ndash]111 [28[ndash]300]s). In nine of the 13 cases, advancement of the SensaSc...

Clinical assessment of a new anaesthetic drug administration system: a prospective, controlled, longitudinal incident monitoring study*

Anaesthesia — Fri, 19 Mar 2010 00:00:00 +0100

A safety-orientated system of delivering parenteral anaesthetic drugs was assessed in a prospective incident monitoring study at two hospitals. Anaesthetists completed an incident form for every anaesthetic, indicating if an incident occurred. Case mix data were collected and the number of drug administrations made during procedures estimated. From February 1998 at Hospital A and from June 1999 at Hospital B, until November 2003, 74 478 anaesthetics were included, for which 59 273 incident forms were returned (a 79.6% response rate). Fewer parenteral drug errors occurred with the new system than with conventional methods (58 errors in an estimated 183 852 drug administrations (0.032%, 95% CI 0.024[ndash]0.041%) vs 268 in 550 105 (0.049%, 95% CI 0.043[ndash]0.055%) respectively, p = 0.002),...

In vitro study of magnetic resonance imaging artefacts of six supraglottic airway devices

Anaesthesia — Fri, 19 Mar 2010 00:00:00 +0100

We investigated the artefacts created during magnetic resonance imaging by five different laryngeal mask airways: the Classic (cLMA[trade]); the LMA ProSeal[trade]; the LMA Unique[trade]; the Ambu® Disposable Laryngeal Mask; the LMA Supreme[trade]; and one other supraglottic airway device, the i-gel supraglottic airway. The devices were placed on top of and inside a phantom simulator to resemble the position in vivo. The artefacts with the cLMA, Unique and Supreme were similar and related to ferromagnetic material in the pilot balloon valve. Artefacts were more prominent with the ProSeal. There were no artefacts with the Ambu Disposable Laryngeal Mask or the i-gel. (Source: Anaesthesia)

Severe hypotension related to cell salvaged blood transfusion in obstetrics

Anaesthesia — Fri, 19 Mar 2010 00:00:00 +0100

Intra-operative blood cell salvage has recently been adopted for use in women at risk of significant haemorrhage during caesarean section. It has also been advocated for use in those patients who refuse allogenic blood transfusion. A 37-year-old pregnant woman (gravida 3, para 2) underwent an elective lower segment caesarean section at 36 weeks for an anterior, major placenta accreta (grade 4). The volume of cell salvaged blood collected during the procedure was 1870 ml. On starting the cell-salvaged blood transfusion, the blood pressure was noted to fall and this was temporally related to the transfusion of the cell-salvaged blood. We review the recent literature and case reports on hypotension related to cell-salvaged blood transfusion. (Source: Anaesthesia)

Differential effects of propofol and isoflurane on the activation of T-helper cells in lung cancer patients

Anaesthesia — Fri, 19 Mar 2010 00:00:00 +0100

It is suggested that activation and differentiation of T-helper cells are required for peri-operative anti-tumor and anti-infection immunity. The present study aimed to evaluate whether propofol stimulates the activation and differentiation of these cells in patients undergoing pulmonary lobectomy for non-small-cell lung cancer. Thirty patients were randomly allocated to receive propofol or isoflurane throughout surgery. The CD4+CD28+ percentage (p < 0.0001) and the ratio of interferon-[gamma]:interleukin-4 (p = 0.001) all increased with propofol but showed no change with isoflurane. In contrast, cortisol increased with isoflurane (p < 0.0001) but not with propofol over time (p = 0.06). We conclude that propofol promotes activation and differentiation of peripheral T-helper cells. (Source:...

Comparison of the C-MAC® videolaryngoscope with the Macintosh, Glidescope®, and Airtraq® laryngoscopes in easy and difficult laryngoscopy scenarios in manikins

Anaesthesia — Fri, 19 Mar 2010 00:00:00 +0100

The C-MAC® comprises a Macintosh blade connected to a video unit. The familiarity of the Macintosh blade, and the ability to use the C-MAC as a direct or indirect laryngoscope, may be advantageous. We wished to compare the C-MAC with Macintosh, Glidescope® and Airtraq® laryngoscopes in easy and simulated difficult laryngoscopy. Thirty-one experienced anaesthetists performed tracheal intubation in an easy and difficult laryngoscopy scenario. The duration of intubation attempts, success rates, number of intubation attempts and of optimisation manoeuvres, the severity of dental compression, and difficulty of device use were recorded. In easy laryngoscopy, the duration of tracheal intubation attempts were similar with the C-MAC, Macintosh and Airtraq laryngoscopes; the Glidescope performed ...

The use of capnography and the availability of airway equipment on Intensive Care Units in the UK and the Republic of Ireland*

Anaesthesia — Fri, 19 Mar 2010 00:00:00 +0100

This study surveyed 315 (96%) of all general, satellite, hepatobiliary, cardiac and neuro-intensive care units in the UK and the Republic of Ireland, finding that only 100 (32%) units always use capnography for tracheal intubation while only 80 (25%) always use capnography for continuous monitoring of patients requiring controlled ventilation. Three hundred and ten (98%) units utilise a checklist of airway equipment, 311 (99%) check its functionality on a daily basis and 296 (94%) units have access to a bronchoscope. Whilst 297 (94%) ICUs have an airway trolley, sufficient equipment for unanticipated difficult intubation was only seen on 33 (10%) of units. Guidelines addressing minimum standards for monitoring and airway safety on ICU are not being met and remain below the standard expecte...

[Fibrodysplasia ossificans progressiva : Anesthetic management of a 2-year-old child.]

Der Anaesthesist — Fri, 19 Mar 2010 00:00:00 +0100

Authors: Iber T, Klösel S, Schoenes B, Zacharowski K Fibromyalgia ossificans progressiva (FOP) is a severely disabling disorder of connective tissue characterized by congenital malformation of the toes, fingers and vertebrae associated with progressive ossification of striated muscles. Anesthetic management of these patients involves preferably general anesthesia as local or regional anesthesia should be avoided due to possible heterotopic ossification. Airway management is determined by the age of the patient and the progression of the disease. Only a few cases in the literature have reported the anesthetic management of FOP patients and to our knowledge only one case has been published on pediatric patients. In adult, cooperative patients awake fiberoptic intubation is recommend...

Colforsin-induced vasodilation in chronic hypoxic pulmonary hypertension in rats

Journal of Anesthesia — Thu, 18 Mar 2010 19:29:44 +0100

Conclusions cAMP-mediated vasodilatory responses without β-adrenergic receptor activation are impaired in structurally remodeled pulmonary arteries from PH rats. In these arteries, endothelial cells presumably play a compensatory role against the impaired cAMP-mediated vasodilatory response by releasing NO (and thereby attenuating the impairment). The results suggest that colforsin could be effective in the treatment of PH. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00540-010-0912-7Authors Ayumu Yokochi, University of Mie Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine 2-174 Edobashi Tsu Mie 514-8507 JapanHiroo Itoh, Nabari City Hospital Department of Internal Medicine 178 Yurigaoka-Nishi-1ban-cho Nabari Mie 518-...

Effect of intraoperative acetated Ringer’s solution with 1% glucose on glucose and protein metabolism

Journal of Anesthesia — Thu, 18 Mar 2010 19:29:43 +0100

Conclusion The infusion of a small dose of glucose (1%) during minor otorhinolaryngeal, head and neck surgeries may suppress protein catabolism without hyperglycemia and hypoglycemia. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00540-010-0926-1Authors Kazumasa Yamasaki, Tottori University Faculty of Medicine Department of Anesthesiology and Critical Care Medicine 36-1 Nishi-cho Yonago 683-8504 JapanYoshimi Inagaki, Tottori University Faculty of Medicine Department of Anesthesiology and Critical Care Medicine 36-1 Nishi-cho Yonago 683-8504 JapanShinsuke Mochida, Tottori University Faculty of Medicine Department of Anesthesiology and Critical Care Medicine 36-1 Nishi-cho Yonago 683-8504 JapanKazumi Funaki, Tottori University Faculty of Medicine De...

Abrupt formation and spontaneous resolution of a right atrial thrombus detected by intraoperative transesophageal echocardiography during replacement of an abdominal aortic aneurysm

Journal of Anesthesia — Thu, 18 Mar 2010 15:35:51 +0100

We report a case of abrupt right atrial thrombus formation and spontaneous resolution, with no events, detected by transesophageal echocardiography during the replacement of an abdominal aortic aneurysm. Content Type Journal ArticleCategory Clinical ReportDOI 10.1007/s00540-010-0923-4Authors Tae-Yun Sung, Konkuk University School of Medicine Department of Anesthesiology and Pain Medicine Hwayang-dong, Gwangjin-gu Seoul 143-729 KoreaSeong-Hyop Kim, Konkuk University School of Medicine Department of Anesthesiology and Pain Medicine Hwayang-dong, Gwangjin-gu Seoul 143-729 KoreaDuk-Kyung Kim, Konkuk University School of Medicine Department of Anesthesiology and Pain Medicine Hwayang-dong, Gwangjin-gu Seoul 143-729 KoreaTae-Gyoon Yoon, Konkuk University School of Medicine Department of...

Postoperative analgesia

Journal of Anesthesia — Thu, 18 Mar 2010 14:14:19 +0100

Content Type Journal ArticleCategory JA SymposiumDOI 10.1007/s00540-010-0920-7Authors Soichiro Inoue, Jichi Medical University Department of Anesthesiology and Critical Care Medicine 3311-1 Yakushiji Simotsuke Tochigi Japan Journal Journal of AnesthesiaOnline ISSN 1438-8359Print ISSN 0913-8668 (Source: Journal of Anesthesia)

Neuropathic pain and neuron–glia interactions in the spinal cord

Journal of Anesthesia — Thu, 18 Mar 2010 14:14:18 +0100

Content Type Journal ArticleCategory JA SymposiumDOI 10.1007/s00540-010-0918-1Authors Tatsuro Kohno, Niigata University Graduate School of Medical and Dental Sciences Division of Anesthesiology 1-757 Asahimachi Niigata 951-8510 Japan Journal Journal of AnesthesiaOnline ISSN 1438-8359Print ISSN 0913-8668 (Source: Journal of Anesthesia)

Recent advances in pain medicine: from bench to bed; August 17, 2009, Kobe, Japan

Journal of Anesthesia — Thu, 18 Mar 2010 14:14:18 +0100

Content Type Journal ArticleCategory JA SymposiumDOI 10.1007/s00540-010-0917-2Authors Toshiaki Minami, Osaka Medical College Department of Anesthesiology 2-7 Daigaku-machi Takatsuki Osaka 569-8686 JapanSoichiro Inoue, Jichi Medical University Department of Anesthesiology and Critical Care Medicine 3311-1 Yakushiji Shimotsuke Tochigi 329-0498 Japan Journal Journal of AnesthesiaOnline ISSN 1438-8359Print ISSN 0913-8668 (Source: Journal of Anesthesia)

Phantom limb pain in the primary motor cortex: topical review

Journal of Anesthesia — Thu, 18 Mar 2010 14:14:16 +0100

Content Type Journal ArticleCategory JA SymposiumDOI 10.1007/s00540-010-0921-6Authors Masahiko Sumitani, University of Tokyo Hospital Department of Anesthesiology and Pain Relief Center 7-3-1 Hongo, Bunkyo-ku Tokyo 113-8655 JapanSatoru Miyauchi, National Institute of Information and Communications Technology Kobe Advanced ICT Research Center Kobe JapanArito Yozu, The University of Tokyo Department of Rehabilitation Medicine, Graduate School of Medicine Tokyo JapanYuko Otake, The University of Tokyo Department of Rehabilitation Medicine, Graduate School of Medicine Tokyo JapanYouichi Saitoh, Osaka University Department of Neurosurgery, Graduate School of Medicine Osaka JapanYoshitsugu Yamada, University of Tokyo Hospital Department of Anesthesiology and Pain Relief Center 7-3-1 Hongo, B...

Zogenix Initiates Pivotal Phase 3 Clinical Trial For Novel Formulation Of Oral Controlled-Release Hydrocodone

Pain / Anesthetics News From Medical News Today — Thu, 18 Mar 2010 10:00:00 +0100

Zogenix, Inc. ("Zogenix"), a privately held pharmaceutical company, announced that it has initiated a pivotal Phase 3 clinical trial with ZX002, a novel, oral, controlled-release formulation of hydrocodone without acetaminophen. ZX002 is being developed for the treatment of moderate to severe pain in individuals who require around-the-clock opioid therapy for the control of pain... (Source: Pain / Anesthetics News From Medical News Today)

Brief Meditation Training Brings Pain Relief

MedicineNet Chronic Pain General — Thu, 18 Mar 2010 07:00:00 +0100

Title: Brief Meditation Training Brings Pain ReliefCategory: Health NewsCreated: 3/17/2010 4:45:00 PMLast Editorial Review: 3/18/2010 (Source: MedicineNet Chronic Pain General)

Rehab Program Gets Back Pain Patients Back to Work Sooner

MedicineNet Chronic Pain General — Thu, 18 Mar 2010 07:00:00 +0100

Title: Rehab Program Gets Back Pain Patients Back to Work SoonerCategory: Health NewsCreated: 3/17/2010 10:10:00 AMLast Editorial Review: 3/18/2010 (Source: MedicineNet Chronic Pain General)

Health Tip: Caring For Your Cast

MedicineNet Chronic Pain General — Thu, 18 Mar 2010 07:00:00 +0100

Title: Health Tip: Caring For Your CastCategory: Health NewsCreated: 3/17/2010 10:10:00 AMLast Editorial Review: 3/18/2010 (Source: MedicineNet Chronic Pain General)

Muscle Cramps

MedicineNet Chronic Pain General — Thu, 18 Mar 2010 07:00:00 +0100

Title: Muscle CrampsCategory: Diseases and ConditionsCreated: 12/31/1997Last Editorial Review: 3/18/2010 (Source: MedicineNet Chronic Pain General)

Acetaminophen Alone Works Well For Postpartum Pain

Pain / Anesthetics News From Medical News Today — Wed, 17 Mar 2010 10:00:00 +0100

For many mothers of newborns, lingering pain from the delivery can interfere with their first days with their infant. A recent review examined whether over-the-counter medications containing acetaminophen Tylenol for example provided adequate relief for such pain and concluded that they are effective... (Source: Pain / Anesthetics News From Medical News Today)

Pelvic Pain And Surgeries In Women Before Interstitial Cystitis/Painful Bladder Syndrome - Chronic Pelvic Pain, BPS And Pelvic Surgical Procedures

Pain / Anesthetics News From Medical News Today — Wed, 17 Mar 2010 08:00:00 +0100

UroToday.com - For years, bladder pain syndrome series have reported apparently high numbers of BPS patients with a history of hysterectomy and other pelvic surgeries. No study has compared cases with controls prior to onset of BPS symptoms... (Source: Pain / Anesthetics News From Medical News Today)

Lidocaine Eye Drops Attenuate Pain Associated with Ophthalmic Postherpetic Neuralgia.

Anesthesia and Analgesia — Wed, 17 Mar 2010 00:00:00 +0100

Conclusions: This study suggests that LDC provides a significant improvement of ophthalmic PHN because of its prompt analgesia, lack of systemic side effects, and convenience of use. PMID: 20237042 [PubMed - as supplied by publisher] (Source: Anesthesia and Analgesia)

Level of Sedation with Nitrous Oxide for Pediatric Medical Procedures.

Anesthesia and Analgesia — Wed, 17 Mar 2010 00:00:00 +0100

Conclusions: A significant number of children remain minimally sedated while receiving N(2)O at concentrations >50% via nasal hood using a system designed to titrate N(2)O concentration from 0% to 70%. Adverse event rates of patients receiving >50% N(2)O in this manner are similar to rates reported in large studies of 50% N(2)O administration. PMID: 20237043 [PubMed - as supplied by publisher] (Source: Anesthesia and Analgesia)

Bilateral Acupuncture Analgesia Observed by Quantitative Sensory Testing in Healthy Volunteers.

Anesthesia and Analgesia — Wed, 17 Mar 2010 00:00:00 +0100

Conclusions: There were congruent changes on QST after 3 common acupuncture stimulation methods, with possible unilateral as well as bilateral effects. PMID: 20237044 [PubMed - as supplied by publisher] (Source: Anesthesia and Analgesia)

Rapid Sequence Induction and Intubation: Current Controversy.

Anesthesia and Analgesia — Wed, 17 Mar 2010 00:00:00 +0100

Authors: El-Orbany M, Connolly LA, Connolly The changing opinion regarding some of the traditional components of rapid sequence induction and intubation (RSII) creates wide practice variations that impede attempts to establish a standard RSII protocol. There is controversy regarding the choice of induction drug, the dose, and the method of administration. Whereas some prefer the traditional rapid injection of a predetermined dose, others use the titration to loss of consciousness technique. The timing of neuromuscular blocking drug (NMBD) administration is different in both techniques. Whereas the NMBD should immediately follow the induction drug in the traditional technique, it is only given after establishing loss of consciousness in the titration technique. The optimal dose of succ...

Inhaled Fluticasone Propionate Reduces Postoperative Sore Throat, Cough, and Hoarseness.

Anesthesia and Analgesia — Wed, 17 Mar 2010 00:00:00 +0100

Conclusions: Inhaled fluticasone propionate decreases the incidence and severity of postoperative sore throat, cough, and hoarseness in patients undergoing cesarean delivery under general anesthesia. PMID: 20237046 [PubMed - as supplied by publisher] (Source: Anesthesia and Analgesia)

The Epidemiology of Postpartum Hemorrhage in a Large, Nationwide Sample of Deliveries.

Anesthesia and Analgesia — Wed, 17 Mar 2010 00:00:00 +0100

Conclusion: PPH is a relatively common complication of delivery and is associated with substantial maternal morbidity and mortality. It is increasing in frequency in the United States. PPH caused by uterine atony resulting in transfusion often occurs in the absence of recognized risk factors. PMID: 20237047 [PubMed - as supplied by publisher] (Source: Anesthesia and Analgesia)

Processed Electroencephalogram During Donation After Cardiac Death.

Anesthesia and Analgesia — Wed, 17 Mar 2010 00:00:00 +0100

We present a case series of increased bispectral index values during donation after cardiac death (DCD). During the DCD process, a patient was monitored with processed electroencephalogram (EEG), which showed considerable changes traditionally associated with lighter planes of anesthesia immediately after withdrawal of care. Subsequently, to validate the findings of this case, processed EEG was recorded during 2 other cases in which care was withdrawn without the use of hypnotic or anesthetic drugs. We found that changes in processed EEG immediately after withdrawal of care were not only reproducible, but can happen in the absence of changes in major electromyographic or electrocardiographic artifact. It is well documented that processed EEG is prone to artifacts. However, in the setting o...

Essentials of cardiac anesthesia

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:26 +0100

‘Essentials of Cardiac Anesthesia’ is the first edition of this title which has been added to the ‘Essentials in Anaesthesia and Critical Care’ series by the Saunders Elsevier publishing house. The book is a new publication written by a distinguished list of North American experts, and edited by Joel A Kaplan, well known for his established textbook ‘Cardiac Anesthesia’, now in its 5th edition. (Source: Current Anaesthesia and Critical Care)

Anaesthesia

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:26 +0100

The intended reader of this book is the new anaesthetic trainee who, with little or no previous anaesthetic experience, expects a basic yet comprehensive insight into the principles of anaesthetic practice and a practical guide to clinical anaesthetic skills. (Source: Current Anaesthesia and Critical Care)

Reply to “Eclampsia a rare complication: A reminder that magnesium sulphate saves lives”

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:25 +0100

We read with great interest the commentary of Durbgidge J, “Eclampsia a rare complication: A reminder that magnesium sulphate saves lives” on our case report “Posterior Reversible Encephalopathy Syndrome (PRES) in a patient of eclampsia with ‘partial’ HELLP-syndrome presenting with status-epilepticus”. We agree with you fully that there is a continuing gap between the availability of healthcare and access to drugs between the developed and developing countries. You have rightly pointed out the important role of magnesium sulphate in the management of preeclampsia and eclampsia and it is an indispensable drug in such a situation. (Source: Current Anaesthesia and Critical Care)

Tumour necrosis factor inhibitors in critical care: Case report with review of the literature

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:25 +0100

Summary: This is a case report of a patient with Crohn's disease admitted to hospital with a typical flare. The main symptoms were abdominal pain and haemorrhagic diarrhoea. During the current admission she was commenced on her first course of Infliximab.The clinical benefits of monoclonal TNF-alpha inhibitors are described. The anxieties relating to infectious complications that may be, in part related to the TNF-alpha inhibition are also discussed. At present the impact of these agents on critical illness is unclear but as the use of these effective drugs increase it is inevitable there will be an increase in patients presenting with critical illness who are concurrently on this treatment. Some of the implications are outlined. (Source: Current Anaesthesia and Critical Care)

A near miss; malpositioned nasogastric tube in the left bronchus of a spontaneously breathing critically-ill patient

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:25 +0100

We report a 60-year male in whom the attempted NGT insertion led to a near fatal complication. He was admitted to the medical intensive care-unit of our institute with dysphagia, cough with expectoration and breathlessness. In an un-cooperative patient with ineffective cough, the administration of sedation and multiple attempts to place the NGT resulted in an impacted tooth in the upper esophagus, and misplacement of the NGT. An urgent chest radiograph showed that the NGT had entered into the airway and its tip lay in the left main bronchus. A brief review of the complications associated with NGT insertion is presented. (Source: Current Anaesthesia and Critical Care)

“To MAP or not to MAP; is that the question?” The role of platelet function tests in the perioperative management of patients on antiplatelet therapy

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:25 +0100

Summary: Platelets aggregate at the site of ruptured atherosclerotic plaques and have a key role in the pathophysiology of occlusive vascular events. Antiplatelet agents (APA) have proven efficacy in the primary and secondary prevention of ischaemic heart and cerebrovascular disease. The peri-operative management of patients taking such drugs is increasingly challenging and necessitates consideration of the risk of thrombosis following cessation of APA versus that of haemorrhage through continuation. We discuss the current and future role of platelet function tests in optimising clinical management of patients taking APA at the time of surgery. (Source: Current Anaesthesia and Critical Care)

Commentary on transfusion triggers

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:24 +0100

In this review article Bunker et al. present their approach to the clinical conundrum regarding the use of red cell transfusion triggers. The impetus to use numerical values of haemoglobin concentration as transfusion triggers has been driven by several factors that have been clearly outlined by the authors. Whilst public perception may differ, blood itself has never been safer and currently the most pressing problem associated with this pharmacological product is the reduction in the donor pool and the exponential rise in cost due to even more sensitive screening tools and pathogen inactivation methods. This has to be tempered with the fact that decisions at the bedside will depend ultimately on the rapidity of blood loss that leads to anaemia and the co morbidities of the patient that m...

Transfusion triggers

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:24 +0100

Summary: Transfusion triggers are increasingly accepted in surgery and in the critically ill. There is very little evidence to suggest a restrictive policy is harmful although higher levels might be sensible in those with cardiovascular disease. A considerable tranche of literature shows that blood is bad for a patient but to date no clear mechanism has emerged and there is an argument that needing blood, a surrogate for illness may be as relevant. The impact of anaemia in the postoperative phase has not been evaluated adequately. The triggers lend themselves to non-acute elective situations but where there is acute blood loss and haemodynamic instability a slightly higher threshold, nearer 10g/dl, allows a margin of safety. (Source: Current Anaesthesia and Critical Care)

Continuing professional development: Renal MCQs and self-assessment

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:24 +0100

True. Pre-existing chronic kidney disease is a risk factor for acute kidney injury (Source: Current Anaesthesia and Critical Care)

Continuing professional development: Renal MCQs and self-assessment questions

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:24 +0100

1. Risk factors for acute kidney injury include Pre-existing chronic kidney disease (Source: Current Anaesthesia and Critical Care)

Management of the peri-operative and critically ill renal transplant patient

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:24 +0100

Summary: Recipients of successful renal transplants experience a markedly improved quality of life and almost certainly improved survival compared to patients treated with dialysis. Haemodialysis treatment in the immediate period prior to transplantation is associated with a poorer outcome including a higher rate of delayed graft function (DGF). Individuals undergoing renal transplantation require close intra-operative monitoring with optimisation of intravascular fluid volume to maximise renal transplant perfusion. Whether mannitol, loop diuretics, dopamine or other therapies influence the rate of DGF is not possible to decide. For renal transplant recipients admitted immediately post-procedure to intensive care unit (ICU) the prognosis is good. This is in contrast to those admitted usual...

Renal replacement therapy in the intensive care unit

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:23 +0100

This article explores the techniques available for renal replacement and support in the intensive care unit, discussing vascular access, choice of technique, choice of membrane, choice of dialysis buffer and strategies for maintaining circuit patency. It examines the techniques in common use in the United Kingdom and the outcome following renal replacement therapy, discussing some of the controversies surrounding renal replacement in terms of timing and dose. It also discusses some future development in technologies for renal replacement. (Source: Current Anaesthesia and Critical Care)

Prevention of acute kidney injury in the intensive care unit

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:23 +0100

Summary: Acute Kidney injury (AKI) is a relatively common condition in the intensive care unit and is associated with an increase in mortality. Whilst it can be treated by the use of renal replacement therapies an independent increase in mortality still exists. It is therefore seems intuitive that the prevention of AKI should be associated with a reduction in both mortality and morbidity and an improvement in patient care for this reason there has been many attempts to develop strategies to reduce the incidence of AKI. These strategies involve the use of therapeutic agents to prevent renal failure, the avoidance of nephrotoxic agents and the maintenance of normal hydration and renal perfusion. More recently there has been focus on the early recognition of patients at risk of developing AKI...

Acute kidney injury in the critically ill patient

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:23 +0100

Abstract: The stage at which acute kidney injury (AKI) is detected is dependent upon the definition used. More recently it has been demonstrated that even relatively small increments of serum creatinine portend a worse outcome. This has prompted the development of new definitions based on small rises in serum creatinine or decreases in urine output. Acute kidney injury on the intensive care unit (ICU) is usually multifactorial secondary to hypovolaemia and sepsis resulting in hypoperfusion of the kidneys. In patients with good baseline kidney function the condition is generally reversible if the patient regains health. However it has been recognised that kidney function does not always completely recover. An episode of AKI may represent an antecedent to the development of chronic kidney di...

Critical care nephrology

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:23 +0100

Over the last few years there has been an increased interest in acute renal failure now termed acute kidney injury (AKI) particularly in relation to its association with increased patient morbidity, mortality and length of hospital stay. The term AKI encompasses all types of acute renal failure (ARF). The National Service Framework (NSF) for Renal Services has recommended that patients at risk of suffering from AKI should be identified promptly, with hospital services delivering high-quality, clinically appropriate care in partnership with specialised teams. (Source: Current Anaesthesia and Critical Care)

Editorial Board & Aims and Scope

Current Anaesthesia and Critical Care — Tue, 16 Mar 2010 13:42:23 +0100

(Source: Current Anaesthesia and Critical Care)

Discovery Of Codeine And Morphine Genes By University Of Calgary Researchers

Pain / Anesthetics News From Medical News Today — Tue, 16 Mar 2010 10:00:00 +0100

Researchers at the University of Calgary have discovered the unique genes that allow the opium poppy to make codeine and morphine, thus opening doors to alternate methods of producing these effective painkillers either by manufacturing them in a lab or controlling the production of these compounds in the plant... (Source: Pain / Anesthetics News From Medical News Today)

Vertebroplasty For Patients With Osteoporosis Provides Effective Pain Relief

Pain / Anesthetics News From Medical News Today — Tue, 16 Mar 2010 08:00:00 +0100

Patient selection is key for vertebroplasty a minimally invasive treatment performed by interventional radiologists in individuals with painful osteoporotic vertebral compression fractures that fail to respond to conventional medical therapy to be effective and successful, according to a study of more than 1,500 persons who were followed over seven years... (Source: Pain / Anesthetics News From Medical News Today)

Forensic Laboratories Develops First Oral Fluid Test For Tapentadol

Pain / Anesthetics News From Medical News Today — Tue, 16 Mar 2010 08:00:00 +0100

Forensic Laboratories, a Denver-based laboratory specializing in toxicology services for drug abuse, has unveiled the first oral fluid test for Tapentadol, a new federally approved drug prescribed by doctors for pain management. Previously, laboratories could only detect the drug through urine using liquid chromatography-mass spectrometry-mass spectrometry (LC/MS/MS) technology... (Source: Pain / Anesthetics News From Medical News Today)

Hip Fracture Risks Linger After Recovery

MedicineNet Chronic Pain General — Tue, 16 Mar 2010 07:00:00 +0100

Title: Hip Fracture Risks Linger After RecoveryCategory: Health NewsCreated: 3/16/2010 10:57:00 AMLast Editorial Review: 3/16/2010 10:57:38 AM (Source: MedicineNet Chronic Pain General)

Meditation Techniques Effective For Pain Relief

Pain / Anesthetics News From Medical News Today — Tue, 16 Mar 2010 07:00:00 +0100

Meditation has analgesic benefits associated with creating a relaxed state of mind and enhancing the ability to moderate reactions to pain, according to new research published in The Journal of Pain, the peer review publication of the American Pain Society... (Source: Pain / Anesthetics News From Medical News Today)

Reducing delirium in elderly patients with hip fracture: a multi-factorial intervention study

Acta Anaesthesiologica Scandinavica — Tue, 16 Mar 2010 00:00:00 +0100

There is an evident need for improved management of elderly patients with trauma in order to avoid common and troublesome complications such as delirium. The aim of this study was to investigate whether an implementation of a multi-factorial program including intensified pre-hospital and perioperative treatment and care could reduce the incidence of delirium in elderly patients with hip fracture, cognitively intact at admission to the hospital. In addition, we explored the factors that characterize patients who developed delirium. A prospective, quasi-experimental design was used. A total of 263 patients with hip fracture ([ge]65 years), cognitively intact at admission, were consecutively included between April 2003 and April 2004. On 1 October 2003, a new program was introduced. All patie...

Disclosure of industry relationships by anesthesiologists: is the conflict of interest resolved?

Current Opinion in Anaesthesiology — Mon, 15 Mar 2010 13:41:58 +0100

Purpose of review: Anesthesiologists are flooded with requests that they themselves reveal their associations with industry and other external sources of financial support and also with stories about adverse outcomes related to poorly managed conflict of interest (COI) in research, education, and clinical practice. Guidelines for evaluating COI in these areas are needed and provision of such guidelines is the goal of this review. Recent findings: The medical literature and lay press provide ample publications outlining the extent of the COI problem and recent efforts to manage COI with numerous opinions on how to best accomplish COI management. The Institute of Medicine has provided significant guidance with a recent exhaustive review with recommendations. The central theme of managing CO...

Challenges that limit meaningful use of health information technology

Current Opinion in Anaesthesiology — Mon, 15 Mar 2010 13:41:57 +0100

Purpose: Health information technology (HIT) is perceived as an essential component for addressing inefficiencies in healthcare. Without understanding the challenges that limit meaningful use of HIT, there is a high chance that institutions will convert complex paper-based systems to expensive digital chaos. Recent findings: Clinical information systems do not communicate with each other automatically because integration of existing data standards is lacking. Data standards for medical specialties need further development. Database architectures are often designed to support single clinical applications and are not easily modified to meet the enterprise-wide needs desired by all end-users. Despite the improvements in charge capture and better access to health information the realized savi...

Progenics To Advance Oral Methylnaltrexone Into Late Stage Clinical Development

Pain / Anesthetics News From Medical News Today — Mon, 15 Mar 2010 11:00:00 +0100

Progenics Pharmaceuticals, Inc. (Nasdaq: PGNX) today announced that it plans to advance oral methylnaltrexone for the treatment of opioid-induced constipation (OIC) into late stage clinical development and will commence a phase 2b/3 clinical trial of a methylnaltrexone tablet in chronic-pain patients in the second half of 2010... (Source: Pain / Anesthetics News From Medical News Today)

Getting Athletes 'Back In The Game' Faster: Minimally Invasive Sports Hernia Repair

Pain / Anesthetics News From Medical News Today — Mon, 15 Mar 2010 08:00:00 +0100

A new minimally invasive sports hernia repair gets athletes back in the game 3 times faster than the traditional repair, according to a new study presented at the American Orthopaedic Society for Sports Medicine's Specialty Day in New Orleans, (March 13). Sports hernia were often difficult to diagnose and prior to this new repair had a lengthy rehabilitation time... (Source: Pain / Anesthetics News From Medical News Today)

Knee Surgeon's Expectations May Differ From Yours

MedicineNet Chronic Pain General — Mon, 15 Mar 2010 07:00:00 +0100

Title: Knee Surgeon's Expectations May Differ From YoursCategory: Health NewsCreated: 3/12/2010 2:10:00 PMLast Editorial Review: 3/15/2010 (Source: MedicineNet Chronic Pain General)

Bad Behavior in Youth Linked to Chronic Pain Later in Life

MedicineNet Chronic Pain General — Mon, 15 Mar 2010 07:00:00 +0100

Title: Bad Behavior in Youth Linked to Chronic Pain Later in LifeCategory: Health NewsCreated: 3/12/2010 2:10:00 PMLast Editorial Review: 3/15/2010 (Source: MedicineNet Chronic Pain General)

High-Impact Sports Might Not Harm Knee Replacements

MedicineNet Chronic Pain General — Mon, 15 Mar 2010 07:00:00 +0100

Title: High-Impact Sports Might Not Harm Knee ReplacementsCategory: Health NewsCreated: 3/12/2010 10:10:00 AMLast Editorial Review: 3/15/2010 (Source: MedicineNet Chronic Pain General)

[Stroke following a viper bite.]

Annales Francaises d'Anesthesie et de Reanimation — Mon, 15 Mar 2010 00:00:00 +0100

Authors: Hsaini Y, Satte A, Balkhi H, Karouache A, Bourezza A PMID: 20236789 [PubMed - as supplied by publisher] (Source: Annales Francaises d'Anesthesie et de Reanimation)

Ondansetron is as effective as diphenhydramine for treatment of morphine-induced pruritus after cesarean delivery

Acta Anaesthesiologica Scandinavica — Mon, 15 Mar 2010 00:00:00 +0100

Subarachnoid (SA) morphine, highly effective for the management of pain after a cesarean delivery, is associated with a significant incidence of pruritus in up to 80% of patients. No previous study has compared the effectiveness of ondansetron (5-HT3 antagonist) vs. diphenhydramine (H1 receptor blocker) for the treatment of this side effect. In this randomized, double-blind study, 113 patients with a pruritus score 3 or 4 (1=absent; 2=mild, no treatment required; 3=moderate pruritus, treatment required; and 4=severe pruritus) after SA morphine 0.2 mg were assigned to group ondansetron, which received 4 mg intravenously (i.v.) ondansetron, and group diphenhydramine, which received 25 mg i.v. diphenhydramine. Patients who continued to have pruritus [ge]3 30 min after the study drug were cons...

Can intraoperative TEE correctly measure residual shunt after surgical repair of ventricular septal defects?

Journal of Anesthesia — Sun, 14 Mar 2010 11:25:14 +0100

Conclusion TEE-derived Qp/Qs lacks the accuracy required to play a crucial role in quantitatively measuring the severity of residual shunt, while two-dimensional TEE can reliably detect residual leakage after VSD closure and lead to optimal judgment on the need for re-repair. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00540-010-0896-3Authors Satoshi Kurokawa, Tokyo Women’s Medical University Department of Anesthesiology, Faculty of Medicine 8-1 Kawadacho, Shinjuku-ku Tokyo 162-8666 JapanTakayuki Honma, Niigata University Department of Anesthesiology, Faculty of Medicine Niigata JapanMiki Taneoka, Niigata University Department of Anesthesiology, Faculty of Medicine Niigata JapanHidekazu Imai, Niigata University Department of Anesthesiology, F...

Electroencephalographic response following midazolam-induced general anesthesia: relationship to plasma and effect-site midazolam concentrations

Journal of Anesthesia — Sun, 14 Mar 2010 11:25:14 +0100

Conclusion Following the induction of general anesthesia with i.v. midazolam 0.2 or 0.3 mg kg−1, the BIS was positively correlated with the relative beta ratio. Despite a rapid decrease in the plasma and effect-site concentrations of midazolam, the average BIS remained >60 for 60 min after induction, reflecting an increased power of the electroencephalographic high-frequency band. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00540-010-0907-4Authors Wakako Miyake, Osaka City University Graduate School of Medicine Department of Anesthesiology 1-5-7 Asahimachi Abeno-ku, Osaka 545-8586 JapanYutaka Oda, Osaka City University Graduate School of Medicine Department of Anesthesiology 1-5-7 Asahimachi Abeno-ku, Osaka 545-8586 JapanYuk...

Remifentanil versus fentanyl compared in a target-controlled infusion of propofol anesthesia: quality of anesthesia and recovery profile

Journal of Anesthesia — Sun, 14 Mar 2010 11:25:14 +0100

Conclusion We concluded that in propofol-based TCI anesthesia under BIS supervision for septorhinoplasty operations, remifentanil was better than fentanyl, especially with respect to emergence from total intravenous anesthesia (TIVA). Furthermore, the durations of anesthesia and operation were rather short, which indicates that fentanyl can be safely used. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00540-010-0898-1Authors Demet Coskun, Gazi University Faculty of Medicine Department of Anesthesiology and Reanimation 06500 Ankara TurkeyHulya Celebi, Gazi University Faculty of Medicine Department of Anesthesiology and Reanimation 06500 Ankara TurkeyGozde Karaca, Gazi University Faculty of Medicine Department of Anesthesiology and Reanimation 0650...

Post-scan: another role of ultrasound in central venous catheter insertion

Journal of Anesthesia — Sun, 14 Mar 2010 11:25:13 +0100

Content Type Journal ArticleCategory Letter to the EditorDOI 10.1007/s00540-010-0897-2Authors Akihiro Suzuki, Asahikawa Medical College Department of Emergence Medicine and Intensive Care 2-1-1-1 Midorigaoka Higashi Hokkaido 078-8510 JapanMai Kishi, Asahikawa Medical College Department of Anesthesiology and Critical Care Medicine Hokkaido 078–8510 JapanAtsushi Kurosawa, Asahikawa Medical College Department of Anesthesiology and Critical Care Medicine Hokkaido 078–8510 JapanHirotsugu Kanda, Asahikawa Medical College Department of Anesthesiology and Critical Care Medicine Hokkaido 078–8510 JapanTakayuki Kunisawa, Asahikawa Medical College Department of Anesthesiology and Critical Care Medicine Hokkaido 078–8510 JapanHiroshi Iwasaki, Asahikawa Medical College Department of Anesthe...

Malignant Hyperthermia Travel Award To San Diego, CA

Pain / Anesthetics News From Medical News Today — Sun, 14 Mar 2010 07:00:00 +0100

MHAUS announces availability of a $1,500 Travel Award to anesthesia resident/fellow or anesthesiologist who is within five years of ending his/her training to attend the 2010 annual meeting of the American Society of Anesthesiologists in San Diego CA. The Daniel Massik Fund at The Foundation for Jewish Philanthropies in Buffalo, NY was established by Mr... (Source: Pain / Anesthetics News From Medical News Today)

Shoulder pain in the adolescent athlete: a multidisciplinary diagnostic approach from the medical, surgical, and imaging perspectives.

Pain Physician — Sun, 14 Mar 2010 06:38:05 +0100

This article is a compilation work authored by a pediatric radiologist, primary care pediatric sports medicine physician and pediatric orthopedic surgeon with the goal of providing a simplified diagnostic approach to the adolescent athlete presenting with shoulder pain. The spectrum of complex diagnoses often confused by innumerable radiologic acronyms can be distilled into common recognizable injury patterns. Once the physiology leading to the injury pattern is understood, the pediatric radiologist can perform a more focused imaging approach and provide a more meaningful interpretation to the referring orthopedic specialist. PMID: 20225102 [PubMed - in process] (Source: Pain Physician)

Strong Period Pain And Excess Weight In Childhood Increase Risk Of Endometriosis

Pain / Anesthetics News From Medical News Today — Sat, 13 Mar 2010 08:00:00 +0100

Queensland Institute of Medical Research (QIMR) scientists have identified a new link between strong period pain experienced in adolescence and early adulthood and the risk of endometriosis. Researchers from QIMR's Gynaecological Cancer Laboratory have found having strong period pain often at an early age doubles a woman's risk of developing endometriosis... (Source: Pain / Anesthetics News From Medical News Today)

[False positive death certification : Does the Lazarus phenomenon partly explain false positive death certification by rescue services in Germany, Austria and Switzerland?]

Der Anaesthesist — Sat, 13 Mar 2010 00:00:00 +0100

Authors: Herff H, Loosen SJ, Paal P, Mitterlechner T, Rabl W, Wenzel V Apart from misdiagnosis, the Lazarus phenomenon, a spontaneous return of circulation after cardiac arrest, is a potential cause for false positive death certification. Because of medicolegal consequences and thus a negative publication bias, the incidence of false positive death certification is unknown. As a false positive death certification results in criminal prosecution and thus media interest, numerous media archives in Germany, Austria and Switzerland were searched for such reports. A total of nine cases of false positive death certification in these three countries were identified since the early 1990s of which eight occurred in an emergency medical service system setting. Apart from a lack of diligence of e...

[Lazarus phenomenon : Spontaneous return of circulation after cardiac arrest and cessation of resuscitation attempts.]

Der Anaesthesist — Sat, 13 Mar 2010 00:00:00 +0100

CONCLUSIONS: In the relevant medical literature, the Lazarus phenomenon is a rare occurrence. It seems to be a phenomenon which has often been described in non-medical literature but not published in medical literature. The pathophysiological mechanisms are poorly understood. In the literature several mechanisms are discussed which could be important for this phenomenon, e.g. autopositive end-expiratory pressure, hyperventilation and alkalosis, hyperkalemia, delayed action of drugs and unobserved minimal vital signs. In the literature it is recommended that patients should be passively monitored for at least 10 min after cessation of resuscitation. However, more scientific experimental investigations seem to be necessary to gain a better understanding of this phenomenon. PMID: 20224948...

[Patent blue V : Inert dye or potent allergen?]

Der Anaesthesist — Sat, 13 Mar 2010 00:00:00 +0100

Authors: Rogler V, Röhm C, Reutershan J Patent blue V is widely used as a food dye. Clinically, patent blue V dye has been increasingly used in oncological surgery to identify the sentinel lymph nodes in breast cancer and other malignancies. The case of a patient who developed severe anaphylactic shock to subcutaneous injection of patent blue V during breast surgery is presented. The clinical course and the anesthesiological management are presented, and the pitfalls that may delay the correct diagnosis are highlighted. PMID: 20224949 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)

[Status asthmaticus : Role of extracorporeal lung assist procedures.]

Der Anaesthesist — Sat, 13 Mar 2010 00:00:00 +0100

Authors: Aniset L, Kalenka A The successful application of a pumpless extracorporeal lung assist procedure ("interventional lung assist, iLA) in three cases of severe refractory status asthmaticus, which could not be solved with conventional pharmacological and respiratory therapy is reported. After an individual risk-benefit analysis such a therapy can be used to reduce lung injury due to invasive mechanical ventilation. Because of the complexity of this therapy it should only be applied in special medical centers with sufficient experience in dealing with extracorporeal lung assist procedures. PMID: 20224950 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)

[Quality of premedication and patient satisfaction after premedication with midazolam, clonidine or placebo : Randomized double-blind study with age-adjusted dosage.]

Der Anaesthesist — Sat, 13 Mar 2010 00:00:00 +0100

CONCLUSION: Midazolam was the most anxiolytic, sedative and favored premedication with the least adverse effects. Most patients would choose midazolam next time. PMID: 20224951 [PubMed - as supplied by publisher] (Source: Der Anaesthesist)

Proceedings of the Anaesthetic Research Society Meeting: The Royal College of Anaesthetists, London, UK * December 3-4, 2009