Dexamethasone concentration affecting rocuronium-induced neuromuscular blockade and sugammadex reversal in a rat phrenic nerve-hemidiaphragm model: An ex vivo study
BACKGROUND The concentration range of dexamethasone that inhibits neuromuscular blockade (NMB) and sugammadex reversal remains unclear. OBJECTIVE To evaluate the effects of dexamethasone on rocuronium-induced NMB and sugammadex reversal. DESIGN Ex vivo study. SETTING Asan Institute for Life Sciences, Asan Medical Center, Korea, from July 2015 to November 2015. ANIMALS One hundred sixty male Sprague–Dawley rats. INTERVENTIONS We assessed the effect of four concentrations of dexamethasone [0, 0.5, 5 (clinical concentrations) and 50 μg ml−1 (experimental concentration)] on partial NMB on 40...
Source: European Journal of Anaesthesiology - October 4, 2018 Category: Anesthesiology Tags: Neuromuscular blocking agents Source Type: research

End-tidal carbon dioxide monitoring improves patient safety during propofol-based sedation for breast lumpectomy: A randomised controlled trial
BACKGROUND The use of sedation is becoming more commonplace. Although pulse oximetry is a standard monitoring procedure during sedation, it cannot accurately detect early hypoventilation. End-tidal carbon dioxide (EtCO2) monitoring can be an earlier indicator of airway compromise; however, the existing literature is limited to a few studies with varying outcomes. OBJECTIVES To evaluate whether EtCO2 monitoring decreases the incidences of CO2 retention and apnoeic events in propofol-based sedation. DESIGN Randomised controlled study. SETTING A tertiary hospital. PATIENTS Two hundred women (aged 18 to 65 years,...
Source: European Journal of Anaesthesiology - October 4, 2018 Category: Anesthesiology Tags: Monitoring Source Type: research

Haemodilution and head-down tilting induce functional injury in the rat optic nerve: A model for peri-operative ischemic optic neuropathy
CONCLUSION An injury partly resembling human ischaemic optic neuropathy can be produced in rats by combining haemodilution and head-down tilt. Significant functional changes were also present with haemodilution alone. Future studies with this partial optic nerve injury may enable understanding of mechanisms of peri-operative ischaemic optic neuropathy and could help discover preventive or treatment strategies. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - October 4, 2018 Category: Anesthesiology Tags: Monitoring Source Type: research

Diagnostic accuracy of inferior vena caval respiratory variation in detecting fluid unresponsiveness: A systematic review and meta-analysis
CONCLUSION Decreased inferior vena caval respiratory variation is moderately accurate in predicting fluid unresponsiveness both in spontaneous and mechanically ventilated patients. The findings of this review should be used in the appropriate clinical context and in conjunction with other clinical assessments of fluid status. IDENTIFIER CRD 42017068028. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - October 4, 2018 Category: Anesthesiology Tags: Monitoring Source Type: research

Intra-operative cutaneous temperature monitoring with zero-heat-flux technique (3M SpotOn) in comparison with oesophageal and arterial temperature: A prospective observational study
CONCLUSION A SpotOn sensor using the ZHF method seems reliable for core temperature monitoring during abdominal surgery when variations in core temperature are slow rather than rapid. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02869828. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - October 4, 2018 Category: Anesthesiology Tags: Monitoring Source Type: research

Association of pre-operative troponin levels with major adverse cardiac events and mortality after noncardiac surgery: A systematic review and meta-analysis
CONCLUSION Current evidence suggests that pre-operative high troponin levels are significantly associated with adverse cardiac events and mortality after noncardiac surgery. TRIAL REGISTRATION This systematic review was registered in the International Prospective Register of Systematic Reviews (Centre for Reviews and Dissemination 42017077837). (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - October 4, 2018 Category: Anesthesiology Tags: Monitoring Source Type: research

Device or target? A paradigm shift in airway management: Implications for guidelines, clinical practice and teaching
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - October 4, 2018 Category: Anesthesiology Tags: Editorial Source Type: research

e-learning: the anaesthesiology media lab of Yale University School of Medicine
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - September 10, 2018 Category: Anesthesiology Tags: Book and media review Source Type: research

The feasibility of pressure measurement during an ultrasound-guided thoracic paravertebral block
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - September 10, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Modified half-the-air technique for continuous pressure monitoring during lumbar plexus block
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - September 10, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

An observational study of skill retention and practice adoption after a workshop on ultrasound-guided neuraxial anaesthesia
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - September 10, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Removal of entrapped epidural catheter: role of muscle relaxation
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - September 10, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

A comparison of the incidence of supraventricular arrhythmias between thoracic paravertebral and intercostal nerve blocks in patients undergoing thoracoscopic surgery: A randomised trial
CONCLUSION After placement of the needle using ultrasound guidance, a single-shot thoracic PVB is a well tolerated and effective technique to reduce the incidences of postoperative SVT and atrial fibrillation in patients undergoing thoracoscopic pulmonary resection. TRIAL REGISTRATION http://www.chictr.org/cn/, registration number: ChiCTR-IOR-17010952. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - September 10, 2018 Category: Anesthesiology Tags: Locoregional anaesthesia Source Type: research

Ultrasound-guided single injection versus continuous sciatic nerve blockade on pain management and mobilisation after total knee arthroplasty (CoSinUS trial): A randomised, triple-blinded controlled trial
BACKGROUND Combining continuous femoral nerve blockade with single injection sciatic nerve blockade is standard peripheral nerve block practice for total knee arthroplasty (TKA) during the first 24 postoperative hours. OBJECTIVES To assess the analgesic benefits and mobilisation capability of continuous sciatic blockade in conjunction with continuous femoral nerve blockade for 72 h after arthroplasty. DESIGN Randomised, triple-blinded controlled trial. SETTING Single-Centre, German University Hospital. PATIENTS In total, 50 patients receiving continuous femoral nerve blockade (5 ml h−1 ropivacaine...
Source: European Journal of Anaesthesiology - September 10, 2018 Category: Anesthesiology Tags: Locoregional anaesthesia Source Type: research

Spinal anaesthesia with chloroprocaine 1% versus total intravenous anaesthesia for outpatient knee arthroscopy: A randomised controlled trial
CONCLUSION Spinal anaesthesia with 40-mg CP 1% leads to a significantly earlier discharge and is cheaper compared with general. TRIAL REGISTRATION German Clinical Trials Register, www.drks.de, identifier: DRKS00005989. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - September 10, 2018 Category: Anesthesiology Tags: Locoregional anaesthesia Source Type: research

Adding sufentanil to ropivacaine in continuous thoracic paravertebral block fails to improve analgesia after video-assisted thoracic surgery: A randomised controlled trial
CONCLUSION Adding 0.25 μg ml−1 sufentanil to 2 mg ml−1 ropivacaine in continuous thoracic paravertebral analgesia for VATS did not reduce morphine consumption or pain scores when compared with ropivacaine alone. We cannot recommend its use for routine clinical practice. Further studies analysing different concentrations and infusion rates of sufentanil are needed before a lack of efficacy can be confirmed. TRIAL REGISTRATION Clinical trial registrations: EudraCT: 2009-014832-38. ClinicalTrials.gov: NCT 01082744. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - September 10, 2018 Category: Anesthesiology Tags: Locoregional anaesthesia Source Type: research

Assessing changes in tissue oxygenation by near-infrared spectroscopy following brachial plexus block for arteriovenous fistula surgery: A prospective observational pilot study
CONCLUSION NIRSth indicates that BPB significantly increases StO2 of the arteriovenous fistula arm in patients undergoing haemodialysis. TRIAL REGISTRATION: Clinicaltrials.gov: NCT03044496 (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - September 10, 2018 Category: Anesthesiology Tags: Locoregional anaesthesia Source Type: research

Efficacy and safety of dexmedetomidine in peripheral nerve blocks: A meta-analysis and trial sequential analysis
BACKGROUND The duration of analgesia provided by nerve blocks is limited if local anaesthetics are administered alone. Therefore, several additives, including dexmedetomidine (DEX), have been investigated in order to prolong postoperative analgesia following single-shot regional anaesthesia. OBJECTIVES The aim of this meta-analysis was to assess the efficacy and safety of the addition of perineural DEX to local anaesthetics compared with local anaesthetics alone or local anaesthetics combined with systemic administration of DEX. DESIGN A systematic review of randomised controlled trials (RCT) with meta-analysis, tr...
Source: European Journal of Anaesthesiology - September 10, 2018 Category: Anesthesiology Tags: Locoregional anaesthesia Source Type: research

Improved lung recruitment and oxygenation during mandatory ventilation with a new expiratory ventilation assistance device: A controlled interventional trial in healthy pigs
CONCLUSION EVA ventilation improves lung aeration via elevated mean tracheal pressure and consequently improves arterial oxygenation at unaltered positive end-expiratory pressure (PEEP) and peak inspiratory pressure (PIP). These findings suggest the EVA mode is a new approach for protective lung ventilation. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - September 10, 2018 Category: Anesthesiology Tags: Ventilation Source Type: research

Protective ventilation during anaesthesia reduces major postoperative complications after lung cancer surgery: A double-blind randomised controlled trial
CONCLUSION Compared with high tidal volume and no PEEP, LPV combining low tidal volume and PEEP during anaesthesia for lung cancer surgery seems to improve postoperative outcomes. TRIALS REGISTRATION ClinicalTrials.gov number: NCT00805077. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - September 10, 2018 Category: Anesthesiology Tags: Ventilation Source Type: research

Lung protection during one-lung ventilation: Another piece in the puzzle
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - September 10, 2018 Category: Anesthesiology Tags: Invited commentary Source Type: research

The 10 fundamental principles of lay resuscitation: Recommendations by the German Resuscitation Council
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - September 10, 2018 Category: Anesthesiology Tags: Editorial Source Type: research

European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium: erratum
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - August 2, 2018 Category: Anesthesiology Tags: Erratum Source Type: research

Epidrum is an unreliable device for identifying the thoracic epidural space
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - August 2, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Comparative study of concordance between bispectral index recordings obtained from the standard frontal and infra-orbital sensor position
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - August 2, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Cardiac arrest during spinal anaesthesia in a patient with undiagnosed Brugada syndrome
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - August 2, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Sudden-onset trismus after respiratory arrest in a patient with an acute exacerbation of hereditary angioedema
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - August 2, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Association between pre-operative biological phenotypes and postoperative pulmonary complications: An unbiased cluster analysis
BACKGROUND Biological phenotypes have been identified within several heterogeneous pulmonary diseases, with potential therapeutic consequences. OBJECTIVE To assess whether distinct biological phenotypes exist within surgical patients, and whether development of postoperative pulmonary complications (PPCs) and subsequent dependence of intra-operative positive end-expiratory pressure (PEEP) differ between such phenotypes. SETTING Operating rooms of six hospitals in Europe and USA. DESIGN Secondary analysis of the ‘PROtective Ventilation with HIgh or LOw PEEP’ trial. PATIENTS Adult patients scheduled...
Source: European Journal of Anaesthesiology - August 2, 2018 Category: Anesthesiology Tags: Perioperative medicine Source Type: research

The LAS VEGAS risk score for prediction of postoperative pulmonary complications: An observational study
CONCLUSION The LAS VEGAS risk score including 13 peri-operative characteristics has a moderate discriminative ability for prediction of PPCs. External validation is needed before use in clinical practice. TRIAL REGISTRATION The study was registered at Clinicaltrials.gov, number NCT01601223. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - August 2, 2018 Category: Anesthesiology Tags: Perioperative medicine Source Type: research

Peri-operative copeptin concentrations and their association with myocardial injury after vascular surgery: A prospective observational cohort study
BACKGROUND Copeptin levels in conjunction with cardiac troponin may be used to rule out early myocardial infarction in patients presenting with chest pain. Raised pre-operative copeptin has been shown to be associated with postoperative cardiac events. However, very little is known about the peri-operative time course of copeptin or the feasibility of very early postoperative copeptin measurement to diagnose or rule-out myocardial injury. OBJECTIVES In this preparatory analysis for a larger trial, we sought to examine the time course of peri-operative copeptin and identify the time at which concentrations returned to ...
Source: European Journal of Anaesthesiology - August 2, 2018 Category: Anesthesiology Tags: Perioperative medicine Source Type: research

Does a hypnosis session reduce the required propofol dose during closed-loop anaesthesia induction?: A randomised controlled trial
CONCLUSION The current study, which was designed to determine the effect of a deep hypnosis session on anaesthesia induction using an automated tool for propofol administration, failed to detect a difference in the required dose of propofol. TRIAL REGISTRATION ClinicalTrials.gov, NCT02249364. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - August 2, 2018 Category: Anesthesiology Tags: Sedation Source Type: research

Placebo versus low-dose ketamine infusion in addition to remifentanil target-controlled infusion for conscious sedation during oocyte retrieval: A double-blinded, randomised controlled trial
BACKGROUND Currently, there is no gold standard for monitored anaesthesia care during oocyte retrieval. OBJECTIVE In our institution, the standard is a conscious sedation technique using a target-controlled infusion (TCI) of remifentanil, titrated to maintain a visual analogue pain score less than 30 mm. This protocol is well accepted by patients but is associated with frequent episodes of respiratory depression. The main objective of this study was to evaluate whether the addition of a continuous intravenous infusion of ketamine could reduce these episodes. DESIGN Controlled, randomised, prospective, double-blin...
Source: European Journal of Anaesthesiology - August 2, 2018 Category: Anesthesiology Tags: Sedation Source Type: research

Safety of moderate-to-deep sedation performed by sedation practitioners: A national prospective observational study
CONCLUSION Moderate-to-deep sedation performed by trained sedation practitioners has a very low rate of unfavourable outcome. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - August 2, 2018 Category: Anesthesiology Tags: Sedation Source Type: research

Implementation of closed-loop-assisted intra-operative goal-directed fluid therapy during major abdominal surgery: A case–control study with propensity matching
BACKGROUND Goal-directed fluid therapy (GDFT) has been associated with improved patient outcomes. However, implementation of GDFT protocols remains low despite growing published evidence and the recommendations of multiple regulatory bodies in Europe. We developed a closed-loop-assisted GDFT management system linked to a pulse contour monitor to assist anaesthesiologists in applying GDFT. OBJECTIVE To assess the impact of our closed-loop system in patients undergoing major abdominal surgery in an academic hospital without a GDFT programme. DESIGN A case–control study with propensity matching. SETTING Opera...
Source: European Journal of Anaesthesiology - August 2, 2018 Category: Anesthesiology Tags: Intravenous fluid therapy Source Type: research

Impact of intra-operative fluid and noradrenaline administration on early postoperative renal function after cystectomy and urinary diversion: A retrospective observational cohort study
CONCLUSION Noradrenaline administration did not increase the risk for AKI. A too restrictive approach to administration of crystalloids was associated with an increased risk for AKI, particularly in older patients, those receiving antihypertensive medication, and those whose surgery was prolonged. As AKI was associated with longer hospital stay and increased postoperative morbidity, these observations should be taken into account to improve outcome when addressing peri-operative fluid management. TRIAL REGISTRATION Not applicable. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - August 2, 2018 Category: Anesthesiology Tags: Intravenous fluid therapy Source Type: research

Postoperative acute kidney injury: A never-ending challenge
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - August 2, 2018 Category: Anesthesiology Tags: Invited commentary Source Type: research

Reply to: quality of evidence in Cochrane systematic reviews in anaesthesia, critical care and emergency medicine
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - July 5, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Quality of evidence in Cochrane systematic reviews in anaesthesia, critical care and emergency medicine
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - July 5, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Reply to: dexamethasone and postoperative cognitive decline
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - July 5, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Dexamethasone and postoperative cognitive decline
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - July 5, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

The European Society of Anaesthesiology research support programme at 15 years
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - July 5, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Comparison of the ease of tracheal intubation using a McGrath Mac videolaryngoscope and a standard Macintosh laryngoscope in normal airways: A randomised trial
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - July 5, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Limited maximal mouth opening in patients with spinal muscular atrophy complicates endotracheal intubation: An observational study
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - July 5, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

The performance of ultrasound-based quantification of the hyomental distance ratio in predicting difficult airway in anaesthesia: A STARD-compliant prospective diagnostic study
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - July 5, 2018 Category: Anesthesiology Tags: Correspondence Source Type: research

Level of agreement between laboratory and point-of-care prothrombin time in patients after stopping or continuation of acenocoumarol anticoagulation: A comparison of diagnostic accuracy
CONCLUSION The current study shows a good level of agreement and clinical accuracy between the laboratory and POC-INR in patients who stopped anticoagulation intake for surgery. However, in patients who continued their anticoagulation therapy, the agreement between the two methods was less accurate. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - July 5, 2018 Category: Anesthesiology Tags: Coagulation Source Type: research

Adjusted calculation model of heparin management during cardiopulmonary bypass in obese patients: A randomised controlled trial
BACKGROUND Anticoagulation during cardiopulmonary bypass (CPB) is usually adapted to total body weight (TBW). This may be inaccurate in obese patients and lead to heparin overdose with a risk of bleeding. OBJECTIVES To validate the efficacy and safety of an adjusted calculation model of heparin dosing based on ideal body weight (IBW) rather than TBW in obese CPB patients, with an expected target mean plasma heparin concentration of 4.5 IU ml−1 after onset of CPB in the experimental group. DESIGN Randomised controlled study. SETTING University hospital. PATIENTS Sixty obese patients (BMI ≥ 30...
Source: European Journal of Anaesthesiology - July 5, 2018 Category: Anesthesiology Tags: Coagulation Source Type: research

Evaluation of two neck ultrasound measurements as predictors of difficult direct laryngoscopy: A prospective observational study
CONCLUSION Airways ultrasounds might be considered as a predictor of restricted/difficult laryngoscopy and unpredicted difficult intubation. TRIAL REGISTRATION ClinicalTrials.gov: NCT03547193. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - July 5, 2018 Category: Anesthesiology Tags: Airway management Source Type: research

Comparison of the laryngeal mask airway supreme and the i-gel in paralysed elderly patients: A randomised controlled trial
BACKGROUND The laryngeal mask airway supreme (LMA-S) and i-gel are both popular second-generation supraglottic airway devices that have been widely studied in surgical patients, but their differences in clinical performance in the elderly are not clear. OBJECTIVE We compared the efficacy and safety of the LMA-S and i-gel in anaesthetised and paralysed elderly patients. DESIGN A randomised study. SETTING Single-centre trial, study period January 2014 from to October 2016. PATIENTS One hundred and six elderly patients who underwent urological or orthopaedic surgery with an expected duration less than 2 h. IN...
Source: European Journal of Anaesthesiology - July 5, 2018 Category: Anesthesiology Tags: Airway management Source Type: research

Emergence times and airway reactions during general anaesthesia with remifentanil and a laryngeal mask airway: A multicentre randomised controlled trial
This study was powered for the primary outcome ‘time to state date of birth’ and the secondary outcome ‘intra-operative cough’. Time to emergence from anaesthesia and the incidence of upper airway complications were assessed on the day of surgery. RESULTS The primary outcome was analysed for 343 patients: desflurane (n=114), sevoflurane (n=111) and propofol (n=118). The desflurane group had the fastest emergence. The mean (± SD) times to state the date of birth following desflurane, sevoflurane and propofol were 8.1 ± 3.6, 10.1 ± 4.0 and 9.8 ± 5.1 min, re...
Source: European Journal of Anaesthesiology - July 5, 2018 Category: Anesthesiology Tags: Airway management Source Type: research

Low perfusion pressure is associated with renal tubular injury in infants undergoing cardiac surgery with cardiopulmonary bypass: A secondary analysis of an observational study
CONCLUSION Maintaining the perfusion pressure above 60% of the normal age-standardised mean arterial pressure may provide an effective renal protective strategy. TRIAL REGISTRATION Registered on October 11, 2010, ClinicalTrials.gov Identifier: NCT01219998. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - July 5, 2018 Category: Anesthesiology Tags: Paediatric anaesthesia Source Type: research