Intravenous patient-controlled analgesia after thoracotomy: a comparison of morphine with tramadol

Background and objective: This study examined the quality of analgesia together with the side-effects produced by tramadol compared with morphine using intravenous patient-controlled analgesia during the first 24 h after thoracotomy

Unilateral high frequency jet ventilation during one-lung ventilation

Fifteen patients undergoing elective thoracic surgery were studied in order to investigate the efficacy of high frequency jet ventilation of the non-dependent lung with respect to arterial oxygenation. During the study PaO2, PaCO2, arterial pressures and heart rate were recorded during ventilation of both lungs in the lateral decubitus position during one-lung ventilation and during high frequency jet ventilation of the non-dependent lung. Mean PaO2 was 28 +/- 8.75 kPa and mean PaCO2 was 5.4 +/- 0.7 kPa during control. During one-lung ventilation, PaO2 dropped to 10.8 +/- 2.57 kPa and PaCO2 rose to 6.3 +/- 0.9 kPa. With high frequency jet ventilation to the non-dependent lung, mean PaO2 increased to 25 +/- 6.75 kPa and PaCO2 decreased to 5.16 +/- 0.9 kPa respectively. Arterial pressures and heart rate remained stable during the study period. In conclusion high frequency jet ventilation of the non-dependent lung was effective in providing arterial normoxaemia and normocapnia during one-lung ventilation

COMPARISON OF INTRAPLEURAL VERSUS INTRAVENOUS MORPHINE FOR POSTTHORACOTOMY PAIN MANAGEMENT

Objective: To compare the analgesic effects of intrapleural and intravenous morphine administration for postthoracotomy pain management

Epidural anesthesia may attenuate lipid peroxidation during aorto-femoral surgery

Purpose: To determine the effect of epidural anesthesia (FP) on oxygenation of the chronically ischemic limb in patients undergoing aorto-femoral bypass grafting and to assess whether it produces an alteration of lipid peroxidation and antioxidant status following revascularization

Distribution of morbidity in diabetic and non-diabetic patients according to intraoperative blood glucose levels in coronary artery bypass greft surgery: our single-center experience of 267 patients

Background: This study aims to investigate the distribution of morbidity in diabetic and non-diabetic patients who were subjected to conservative glycemic control during coronary artery bypass graft (CABG) surgery and to determine the efficacy of this strategy according to currently recommended target intraoperative blood glucose value

The effects of pentoxyphiline on neurocognitive functions and neurobiochemical markers in coronary artery bypass graft surgery

Aim: Neurocognitive dysfunction is a complication of cardiopulmonary bypass (CPB). Neuron-specific enolase (NSE) and S100ß protein are markers of cerebral injury. With its beneficial rheological and anti-inflammatory properties, pentoxyphiline (PTX) is an interesting agent in cardiac surgery patients. The study was designed to evaluate the influence of prophylactic use of PTX on cognitive function and S100ß and NSE in on-pump coronary artery bypass grafting (CABG) patients.Method: In this prospective study, 40 patients undergoing on-pump CABG and received either PTX (bolus of 5 mg kg-1) after induction of anesthesia or saline are included. Neurological examination and neuropsychologic tests, including the mini-mental state examination test (MMSET) and Benton visual retention test (BVRT), were obtained preoperatively and on the seventh postoperative day. Blood samples for analysis of S100ß and NSE were collected before anesthesia, at the end of CPB, at the 3rd hour and 24th hour postoperatively.Results: Demographic and perioperative data were similar for the two groups. Mean cross-clamping times were 67.86±22.22 and 66.32±27.84 min, respectively. In both groups, S100ß and NSE increased significantly (p0.05). MMSET and BVRT performances of the two groups were similar and did not change compared to preoperative scores.Conclusions: Coronary artery bypass surgery caused a significant increase in NSE and S100ß serum levels but with no deterioration in neuropsychological outcome assessed in the first postoperative week. Although it was reported that PTX could be a promising agent to prevent post-CPB organ dysfunction in elderly cardiac surgery patients, prophylactic use of PTX appeared to offer no advantage for cerebral protection in the age group involved in this study