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BACKGROUND Interscalene brachial plexus block (ISB) provides excellent, but time-limited analgesia. Dexamethasone added to local anaesthetics prolongs the duration of a single-shot ISB. However, systemic glucocorticoids also improve postoperative analgesia. The hypothesis was tested that perineural and i.v. dexamethasone would have an equivalent effect on(More)
BACKGROUND AND OBJECTIVE During off-pump coronary bypass grafting, surgical manipulation and dislocation of the heart may cause cardiovascular instability. Monitoring of cardiac output facilitates intraoperative haemodynamic management but pulmonary artery catheters are often considered too invasive. Pulse contour analysis and transoesophageal(More)
Hypotension remains an important side effect of spinal anesthesia for cesarean delivery. There is limited evidence that reducing the spinal dose has a favorable effect on maternal hemodynamic stability. We designed the present randomized trial to test the hypothesis that reducing the spinal dose of local anesthetics results in equally effective anesthesia(More)
Patient-controlled epidural analgesia (PCEA) is used to maintain epidural analgesia following initial intrathecal analgesia. This trial investigated whether a continuous background infusion with PCEA provides superior analgesia to PCEA alone among patients who received combined spinal-epidural (CSE) analgesia during labour Eighty parturients were randomized(More)
OBJECTIVE Experimental data suggest that levosimendan has pulmonary vasodilatory properties which, in combination with its positive inotropic effects, would render it particularly attractive for the treatment of right ventricular dysfunction. To test this hypothesis, we developed an experimental model of right ventricular failure and analyzed the effects of(More)
We recruited patients scheduled for shoulder rotator cuff repair or subacromial decompression under general anaesthesia and interscalene brachial plexus blockade (30 ml ropivacaine 0.5%). We allocated 240 participants into four groups of 60 that were given pre-operative saline 0.9% or dexamethasone 1.25 mg, 2.5 mg or 10 mg, intravenously. We recorded(More)
PURPOSE Intrathecal clonidine prolongs total duration of spinal bupivacaine analgesia. However, there are contradictory reports about its effect on maternal blood pressure and only limited data are available on fetal and neonatal outcome. In this study, we evaluated the efficacy of spinal clonidine combined with ropivacaine and sufentanil and its effects on(More)
OBJECTIVE Doppler myocardial imaging is increasingly being used to evaluate regional and global cardiac function. Quantitative measurements of tissue deformation obtained during ejection as well as isovolumic contraction have been proposed as new indices of contractility; however, their load-sensitivity remains a matter of controversy. Maximum strain rate(More)
OBJECTIVE Thoracic epidural anesthesia is increasingly used in critically ill patients. This analgesic technique was shown to decrease left ventricular contractility, but effects on right ventricular function have not been reported. A deterioration of right ventricular performance may be clinically relevant for patients with acute pulmonary hypertension, in(More)
Prostacyclins have been suggested to exert positive inotropic effects which would render them particularly suitable for the treatment of right ventricular (RV) dysfunction due to acute pulmonary hypertension (PHT). Data on this subject are controversial, however, and vary with the experimental conditions. We studied the inotropic effects of epoprostenol at(More)