Thoracic Epidural Analgesia With Levobupivacaine Reduces Remifentanil and Propofol Consumption Evaluated by Closed-Loop Titration Guided by the Bispectral Index: A Double-Blind Placebo-Controlled Study.

Background: Thoracic epidural analgesia (TEA) combined with general anesthesia decreases anesthetic requirements by half when hemodynamic criteria are used for the titration of analgesia. We therefore determined the impact of TEA on anesthetic requirements, when a closed-loop controller was used allowing the automated coadministration of propofol-remifentanil guided solely by the Bispectral index.

Methods: This single-center double-blind study enrolled patients scheduled for elective posterolateral thoracotomy using TEA.

Feasibility and results of a fast-track protocol in thoracic surgery.

Background: A rehabilitation program, a multimodal strategy favoring rapid postoperative return to autonomy, has rarely been undertaken after thoracic surgery compared to colectomy. The primary outcome of this fast-track program was the length of postoperative stay. Secondary outcomes concerned the feasibility of this strategy, the incidence of postoperative complications and 3-month postoperative mortality.

Left double-lumen tube with or without a carinal hook: A randomised controlled trial.

Background: Left double-lumen tracheal tubes (DLTs), with or without a hook to engage the carina, remain the standard device for lung isolation during anaesthesia.

Objective: The purpose of the study was to compare these DLTs with and without a hook.

Design: A randomised, controlled, single-blinded study.

Intraoperative occurrence of a pneumopericardium during double-lung transplantation.

Pneumopericardium is rare and has been reported secondary to chest trauma. We report a case of tension pneumopericardium occurring during double-lung transplantation, where intraoperative transoesophageal echocardiography first showed a hypokinetic left ventricle and a few minutes later a compression of its anterolateral portion due to pneumopericardium. Although the pericardium was opened, left ventricular function remained depressed, necessitating extracorporeal membrane oxygenation, which was withdrawn after 48 h of assistance when left ventricular function had recovered.

A comparison of the deflecting-tip bronchial blocker with a wire-guided blocker or left-sided double-lumen tube.

Objective: To compare a new bronchial blocker, the Cohen blocker, with the Arndt blocker and a left double-lumen tube (DLT).

Design: A prospective, randomized, controlled trial.

Setting: University hospital.

Redistribution of cardiac output during hemorrhagic shock in sheep.

Objective: Our goal was to evaluate the robustness of one of the assumptions used by esophageal Doppler monitors to compute systemic stroke volume and cardiac output; i.e., a constant flow proportion between supra-aortic vessels and descending aorta.