Prewarming Parturients for Cesarean Section Does Not Raise Wound Temperature But Body Heat and Level of Comfort: A Randomized Trial.

Purpose: Prewarming before cesarean section lowers the rates of surgical site infections (SSIs). We hypothesized that this effect is explained due to a higher core temperature resulting in a higher wound temperature.

Design: We conducted an open-labeled randomized study with on-term parturients scheduled for elective cesarean section under spinal anesthesia.

[Case report about an initial diagnosis of HIV-infection in a young sailor through two AIDS-defining diseases with lethal progression].

Anamnesis: We saw a previously healthy 30-year-old Southeast-Asian sailor with progredient coughing and fever.

Examination: We found an atypical pneumonia along with a positive HIV-test. We performed a bronchial lavage and further diagnostics for opportunistic infections.

[Lethal Heatstroke with Disseminated Intravascular Coagulopathy].

We report on a case of severe heat stroke due to extended exposure to the sun in an enclosed glass cabin of an agricultural vehicle. Patient treatment, lab results and complications are reported and we examine the current literature on heat stroke.Heat stroke is a very rare and highly severe condition mostly suffered by vulnerable individuals or individuals exposed to extreme physical strain.

Recognizing Preventable Death: Is There a Role of Survival Prediction Algorithms?

Monitoring the quality of trauma care is important but particularly challenging. Preventable death assessment aims to identify those cases where the patient's death would have not occurred if the patient had been treated differently. Determination of preventable death in trauma care is often based on calculated probability of survival, commonly by using the Trauma and Injury Severity Score (TRISS).

Comparison of distribution of lung aeration measured with EIT and CT in spontaneously breathing, awake patients1.

Background: Both Electrical Impedance Tomography (EIT) and Computed Tomography (CT) allow the estimation of the lung area. We compared two algorithms for the detection of the lung area per quadrant from the EIT images with the lung areas derived from the CT images.

Methods: 39 outpatients who were scheduled for an elective CT scan of the thorax were included in the study.

Checklists and Other Cognitive Aids For Emergency And Routine Anesthesia Care-A Survey on the Perception of Anesthesia Providers From a Large Academic US Institution.

Background: The use of printed or electronic checklists and other cognitive aids has gained increasing interest from anesthesia providers and professional societies. While these aids are not currently considered standard of care, the perceptions of the clinician might have an impact on their adoption.

Objectives: We conducted a comprehensive survey to study the current opinions of anesthesia provider on the use of checklists and other cognitive aids.

Effect of Trigger Sensitivity on Redistribution of Ventilation During Pressure Support Ventilation Detected by Electrical Impedance Tomography.

Background: In supine position, pressure support ventilation causes a redistribution of ventilation towards the ventral regions of the lung. Theoretically, a less sensitive support trigger would cause the patient to breathe more actively, potentially attenuating the effect of positive pressure ventilation.

Objectives: To quantify the effect of trigger setting, we assessed redistribution of ventilation during pressure support ventilation (PSV) using electrical impedance tomography (EIT).

The Relationship of Pain and Nausea in Postoperative Patients for 1 Week After Ambulatory Surgery.

Objectives: The purpose of this study was to determine if pain level was associated with demographic or surgery-specific characteristics among patients recovering from ambulatory surgery; and to assess the relationship between pain level and nausea over the 7-day postoperative period, controlling for demographic and surgery-related covariates.

Materials And Methods: This longitudinal study assessed the pain and nausea of 248 eligible patients during the day of surgery (DOS) and the 7 days following ambulatory surgery. Postoperative data were assessed using standardized questions about severity of pain and nausea symptoms.

Comparison of Two Clinical Protocols for Total Intravenous Anesthesia (TIVA) for Breast Surgery Using Propofol Combined With Either Sufentanil or Alfentanil.

Background: Sufentanil and alfentanil have pharmacokinetic and dynamic properties which make them favourable substances for total intravenous anesthesia (TIVA) in combination with propofol.

Objectives: We planned to compare two clinical protocols for TIVA with propofol, and either sufentanil or alfentanil in regards to postoperative pain, hemodynamic stability during the case and time for emergence from anesthesia.

Patinets And Methods: Treaty eight patients scheduled for general anesthesia for breast surgery were included in this Double-blind, randomized, controlled trial.

Efficacy and safety of thromboprophylaxis with low-molecular-weight heparin or rivaroxaban in hip and knee replacement surgery: findings from the ORTHO-TEP registry.

Prospective trials have shown that rivaroxaban thromboprophylaxis is superior over low-molecular-weight heparin (LMWH) in patients undergoing hip and knee replacement surgery. However, patients treated under trial conditions are different from unselected routine patients, which may affect efficacy and safety of thromboprophylaxis. The objective was to evaluate the efficacy and safety of rivaroxaban or LMWH thromboprophylaxis in unselected patients undergoing hip and knee replacement surgery in daily care.

Who is at risk for postdischarge nausea and vomiting after ambulatory surgery?

Background: About one in four patients suffers from postoperative nausea and vomiting. Fortunately, risk scores have been developed to better manage this outcome in hospitalized patients, but there is currently no risk score for postdischarge nausea and vomiting (PDNV) in ambulatory surgical patients.

Methods: We conducted a prospective multicenter study of 2,170 adults undergoing general anesthesia at ambulatory surgery centers in the United States from 2007 to 2008.

Spontaneous breathing during general anesthesia prevents the ventral redistribution of ventilation as detected by electrical impedance tomography: a randomized trial.

Background: Positive-pressure ventilation causes a ventral redistribution of ventilation. Spontaneous breathing during general anesthesia with a laryngeal mask airway could prevent this redistribution of ventilation. We hypothesize that, compared with pressure-controlled ventilation, spontaneous breathing and pressure support ventilation reduce the extent of the redistribution of ventilation as detected by electrical impedance tomography.

Cost analysis of two anaesthetic machines: "Primus®" and "Zeus®".

Background: Two anaesthetic machines, the "Primus®" and the "Zeus®" (Draeger AG, Lübeck, Germany), were subjected to a cost analysis by evaluating the various expenses that go into using each machine.

Methods: These expenses included the acquisition, maintenance, training and device-specific accessory costs. In addition, oxygen, medical air and volatile anaesthetic consumption were determined for each machine.

Prevention of pain on injection of propofol: systematic review and meta-analysis.

Objective: To systematically determine the most efficacious approach for preventing pain on injection of propofol.

Design: Systematic review and meta-analysis.

Data Sources: PubMed, Embase, Cochrane Library, www.

Two serial check valves can prevent cross-contamination through intravenous tubing during total intravenous anesthesia.

Background: Nonsterile handling of propofol for anesthesia has been linked with severe sepsis and death. Placing a single check valve in the IV tubing does not prevent retrograde ascension of pathogens into propofol-filled syringes, so we designed an IV tubing set with multiple check valves. To estimate the efficacy of this design, we measured the concentration of pathogens detected upstream in the IV tubing in relation to the pathogen concentration in a model of a contaminated patient.

Routine use of nasogastric tubes does not reduce postoperative nausea and vomiting.

Routine use of a nasogastric (NG) tube has been suggested to prevent postoperative nausea and vomiting (PONV) despite conflicting data. Accordingly, we tested the hypothesis that routine use of a NG tube does not reduce PONV. Our work is based on data from a large trial of 4055 patients initially designed to quantify the effectiveness of combinations of antiemetic treatments for the prevention of PONV.

The effect of postoperative fasting on vomiting in children and their assessment of pain.

Background: Mandatory postoperative food intake has been shown to increase nausea and vomiting, and so postoperative fasting has become common practice even if patients request food or drink.

Objective: We sought to investigate whether postoperative fasting reduces the incidence of postoperative vomiting in children when compared with a liberal regimen in which they are allowed to eat and drink upon request.

Methods: One hundred forty-seven children scheduled for outpatient surgery were randomized to one of two groups.

A simple clinical maneuver to reduce laparoscopy-induced shoulder pain: a randomized controlled trial.

Objective: To estimate the efficacy of a simple clinical maneuver that facilitates removal of residual abdominal carbon dioxide (CO2) after laparoscopic surgery to reduce shoulder pain.

Methods: A total of 116 female outpatients who were scheduled for elective gynecologic laparoscopic surgery were randomly allocated to either the current standard (control group) or to additional efforts to remove residual CO2 at the end of surgery. In the control group, CO2 was removed by passive deflation of the abdominal cavity through the cannula.