Volume 30 | e-Supplement 51 | June 2013 www.ejanaesthesiology.com E U R O P E A N J O U R N A L O F A N A MAY 31 - JUNE 3 E S T H E S STOCKHOLM, SWEDEN IO L O G Y European Journal 2014 of V o Euroanaesthesia lum Anaesthesiology e 3 0 e -S u p p le m e The European Anaesthesiology Congress n t 5 1 Ju n e 2 0 1 3 Euroanaesthesia 2013 The European Anaesthesiology Congress Abstracts Programme Barcelona, Spain, June 1-4, 2013 Symposia Refresher Courses Workshops Industrial Symposia & Exhibition Abstract Presentations CME Accreditation EACCME - UEMS Registration P +32 (0)2 743 32 90 F +32 (0)2 743 32 98 E [email protected] www.euroanaesthesia.org 5 1 2 0 Abstract submission from 65- 2 Friday 1 November to 0 N Sunday 15 December 2013 SS I ESA omslag.indd 1 European Journal of Anaesthesiology Volume 30 | e-Supplement 51 | June 2013 Abstracts and Programme EUROANAESTHESIA 2013 The European Anaesthesiology Congress 1 - 4 June 2013 Barcelona, Spain European Journal of Anaesthesiology Editor-in-Chief Associate Editors Per H. Rosenberg Helsinki, Finland Martin R. Tramèr Geneva, Switzerland Bernd W. Böttiger Cologne, Germany Charles-Marc Samama Paris, France Malachy Columb Manchester, UK Francis Veyckemans Brussels, Belgium Stefan G. De Hert Ghent, Belgium Deputy Editors-in-Chief Pierre Diemunsch Strasbourg, France Methods, Statistics, Epidemiology Walid Habre Geneva, Switzerland Argyro Fassoulaki Athens, Greece Nadia Elia Geneva, Switzerland Bernhard Walder Geneva, Switzerland Thomas Fuchs-Buder Nancy, France Peter Kranke Würzburg, Germany Journal Manager Language Editors Patricia M. Lavand’homme Brussels, Belgium Bridget M. Benn Geneva, Switzerland Alan Aitkenhead Nottingham, UK Doris Østergaard Copenhagen, Denmark Gordon Lyons Leeds, UK Rolf Rossaint Aachen, Germany Michael H. Nathanson Nottingham, UK Matt Wiles, Sheffi eld, UK European Journal of Anaesthesiology is the offi cial publication of Advertising enquiries The Point of Difference Ltd., the European Society of Anaesthesiology. 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Poster presenters have been asked to stand by their poster for 45 minutes before and 30 minutes after their session, to address further questions. Date Time Reference Location Page ESA Best Abstract Prize Competition (BAPC) 02.06.2013 14:00-15:30 ESAPC1 Room 120 1 Best Abstracts - Runner-up Sessions 02.06.2013 08:30-10:00 ESAAP1 Room 120 3 02.06.2013 10:30-12:00 ESAAP2 Room 120 5 Subcommittee 1 - Evidence-based Practice and Quality Improvement 01.06.2013 15:00-16:30 01AP1 Poster Area - ROW 1B 7 01.06.2013 15:00-16:30 01AP2 Poster Area - ROW 2B 10 03.06.2013 12:15-13:45 01AP3 Poster Area - ROW 1B 12 03.06.2013 14:00-15:30 01AP4 Poster Area - ROW 10A 15 03.06.2013 14:00-15:30 01AP5 Poster Area - ROW 11A 18 03.06.2013 16:00-17:30 01AP6 Poster Area - ROW 11B 21 03.06.2013 16:00-17:30 01AP7 Poster Area - ROW 12B 24 04.06.2013 08:30-10:00 01AP8 Poster Area - ROW 1A 28 Subcommittee 2 - Ambulatory Anaesthesia 02.06.2013 08:30-10:00 02AP1 Poster Area - ROW 1A 31 02.06.2013 10:30-12:00 02AP2 Poster Area - ROW 1B 34 Subcommittee 3 - Monitoring: Equipment and Computers 02.06.2013 14:00-15:30 03AP1 Poster Area - ROW 5B 37 02.06.2013 14:00-15:30 03AP2 Poster Area - ROW 6B 40 03.06.2013 10:30-12:00 03AP3 Poster Area - ROW 1A 43 03.06.2013 12:15-13:45 03AP4 Poster Area - ROW 2B 46 03.06.2013 14:00-15:30 03AP5 Poster Area - ROW 12A 48 04.06.2013 08:30-10:00 03AP6 Poster Area - ROW 2A 51 Subcommittee 4 - Clinical and Experimental Circulation 02.06.2013 10:30-12:00 04AP1 Poster Area - ROW 2B 54 02.06.2013 10:30-12:00 04AP2 Poster Area - ROW 3B 58 02.06.2013 16:00-17:30 04AP3 Poster Area - ROW 10B 61 02.06.2013 16:00-17:30 04AP4 Poster Area - ROW 11B 63 03.06.2013 10:30-12:00 04AP5 Poster Area - ROW 2A 67 03.06.2013 10:30-12:00 04AP6 Poster Area - ROW 3A 70 03.06.2013 12:15-13:45 04AP7 Poster Area - ROW 3B 73 03.06.2013 14:00-15:30 04AP8 Poster Area - ROW 13B 76 Date Time Reference Location Page Subcommittee 5 - Respiration 03.06.2013 14:00-15:30 05AP1 Poster Area - ROW 14B 80 03.06.2013 14:00-15:30 05AP2 Poster Area - ROW 15B 83 04.06.2013 08:30-10:00 05AP3 Poster Area - ROW 3A 86 04.06.2013 08:30-10:00 05AP4 Poster Area - ROW 4A 89 Subcommittee 6 - Transfusion and Haemostasis 02.06.2013 14:00-15:30 06AP1 Poster Area - ROW 7B 92 02.06.2013 14:00-15:30 06AP2 Poster Area - ROW 15B 95 02.06.2013 16:00-17:30 06AP3 Poster Area - ROW 12B 98 Subcommittee 7 – Neurosciences 01.06.2013 15:00-16:30 07AP1 Poster Area - ROW 3B 101 01.06.2013 15:00-16:30 07AP2 Poster Area - ROW 4B 104 02.06.2013 16:00-17:30 07AP3 Poster Area - ROW 13A 107 02.06.2013 16:00-17:30 07AP4 Poster Area - ROW 14A 110 04.06.2013 08:30-10:00 07AP5 Poster Area - ROW 5B 112 Subcommittee 8 - Regional Anaesthesia 02.06.2013 10:30-12:00 08AP1 Poster Area - ROW 5A 116 02.06.2013 10:30-12:00 08AP2 Poster Area - ROW 6A 119 02.06.2013 14:00-15:30 08AP3 Poster Area - ROW 8B 122 02.06.2013 14:00-15:30 08AP4 Poster Area - ROW 9A 125 03.06.2013 10:30-12:00 08AP5 Poster Area - ROW 4A 128 03.06.2013 10:30-12:00 08AP6 Poster Area - ROW 5B 131 03.06.2013 12:15-13:45 08AP7 Poster Area - ROW 4B 134 03.06.2013 12:15-13:45 08AP8 Poster Area - ROW 5A 136 Subcommittee 9 – Pharmacology 01.06.2013 15:00-16:30 09AP1 Poster Area - ROW 5A 139 02.06.2013 08:30-10:00 09AP2 Poster Area - ROW 2A 142 02.06.2013 08:30-10:00 09AP3 Poster Area - ROW 3A 145 02.06.2013 16:00-17:30 09AP4 Poster Area - ROW 15A 148 02.06.2013 16:00-17:30 09AP5 Poster Area - ROW 16A 151 03.06.2013 10:30-12:00 09AP6 Poster Area - ROW 6B 154 Subcommittee 10 - Paediatric Anaesthesia and Intensive Care 02.06.2013 16:00-17:30 10AP1 Poster Area - ROW 17B 157 03.06.2013 14:00-15:30 10AP2 Poster Area - ROW 16B 159 04.06.2013 08:30-10:00 10AP3 Poster Area - ROW 6B 162 Subcommittee 11 - Obstetric Anaesthesia 01.06.2013 15:00-16:30 11AP1 Poster Area - ROW 6A 165 02.06.2013 16:00-17:30 11AP2 Poster Area - ROW 18B 168 02.06.2013 16:00-17:30 11AP3 Poster Area - ROW 19B 172 03.06.2013 14:00-15:30 11AP4 Poster Area - ROW 17A 175 03.06.2013 14:00-15:30 11AP5 Poster Area - ROW 18A 177 Date Time Reference Location Page Subcommittee 12 - Intensive Care Medicine 02.06.2013 14:00-15:30 12AP1 Poster Area - ROW 10A 181 02.06.2013 14:00-15:30 12AP2 Poster Area - ROW 11A 184 02.06.2013 14:00-15:30 12AP3 Poster Area - ROW 12A 187 03.06.2013 12:15-13:45 12AP4 Poster Area - ROW 6A 190 03.06.2013 12:15-13:45 12AP5 Poster Area - ROW 7A 194 03.06.2013 12:15-13:45 12AP6 Poster Area - ROW 8A 197 Subcommittee 13 - Resuscitation and Emergency Medicine 02.06.2013 10:30-12:00 13AP1 Poster Area - ROW 7A 200 03.06.2013 10:30-12:00 13AP2 Poster Area - ROW 7B 202 Subcommittee 14 - Acute and Chronic Pain Management 01.06.2013 15:00-16:30 14AP1 Poster Area - ROW 7A 204 01.06.2013 15:00-16:30 14AP2 Poster Area - ROW 8A 207 02.06.2013 14:00-15:30 14AP3 Poster Area - ROW 13B 210 02.06.2013 14:00-15:30 14AP4 Poster Area - ROW 14B 213 03.06.2013 10:30-12:00 14AP5 Poster Area - ROW 8B 215 03.06.2013 12:15-13:45 14AP6 Poster Area - ROW 9B 217 03.06.2013 16:00-17:30 14AP7 Poster Area - ROW 13A 220 03.06.2013 16:00-17:30 14AP8 Poster Area - ROW 14A 223 Subcommittee 15 - Education, Research and Presentation 02.06.2013 08:30-10:00 15AP1 Poster Area - ROW 4A 226 03.06.2013 16:00-17:30 15AP2 Poster Area - ROW 15A 228 03.06.2013 16:00-17:30 15AP3 Poster Area - ROW 16A 230 Subcommittee 17 - Patient Safety 03.06.2013 12:15-13:45 17AP1 Poster Area - ROW 10B 233 04.06.2013 08:30-10:00 17AP2 Poster Area - ROW 7B 236 04.06.2013 08:30-10:00 17AP3 Poster Area - ROW 8B 239 04.06.2013 08:30-10:00 17AP4 Poster Area - ROW 10A 242 Subcommittee 18 - Perioperative Care of the Elderly 02.06.2013 10:30-12:00 18AP1 Poster Area - ROW 8A 244 03.06.2013 14:00-15:30 18AP2 Poster Area - ROW 19A 246 Subcommittee 19 - Airway Management 01.06.2013 15:00-16:30 19AP1 Poster Area - ROW 9B 249 02.06.2013 10:30-12:00 19AP2 Poster Area - ROW 9B 252 03.06.2013 10:30-12:00 19AP3 Poster Area - ROW 9A 255 03.06.2013 16:00-17:30 19AP4 Poster Area - ROW 17B 259 03.06.2013 16:00-17:30 19AP5 Poster Area - ROW 18B 262 04.06.2013 08:30-10:00 19AP6 Poster Area - ROW 11A 266 Subject Index Author Index 271 277 The abstracts published in this Supplement have been typeset from electronic submissions and camera-ready copies prepared by the au- thors. Every effort has been made to reproduce faithfully the abstracts as submitted. These abstracts have been prepared in accordance with the requirements of the European Society of Anaesthesiology and have not been subjected to review nor editing by the European Journal of Anaesthesiology. However, no responsibility is assumed by the organisers or publisher for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of methods, products, instructions or ideas contained in the material herein. Because of the rapid advances in medical sciences, we recommend that independent verification of diagnoses and drug doses should be made. Call for abstracts The ESA solicits the submission of abstracts for the Euroanaesthesia 2014 Congress Stockholm, Sweden May 31 - June 3 2014 All abstracts must be submitted online via the ESA Website www.euroanaesthesia.org The submission module will be available to submitters from November to December 2013 Submission Conditions When submitting your abstract, you will be prompted to accept the sub mission conditions that will be made available on the ESA website at least one month before the submission starts. ESA Best Abstract Prize Competition (BAPC) 1 ESA Best Abstract Prize Competition (BAPC) ESAPC1-1 The neuroprotective effects of oxaloacetate and puruvate in POV (RR 0.48 [0.31, 0.74]) and late POV (RR 0.50 [0.35, 0.73]; Figure 2). a rat model of subarachnoid hemorrhage is mediated by its NCoo nrcelgurseisosniosn: asymmetry test results for the funnel plots were statistically blood glutamate scavenging activity significant. This meta-analysis excluding Fujii et al.’s RCTs suggests that ramosetron has a significant effect in preventing PON and/or POV compared Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion BUoniyvkeors Mity., oGf rtuheen Nbeaguemv ,S D.Ee.p, aGrrtumeennbt aouf mAn Be.sF.t,h Desuiboilloegt yM a.,n Zdl oCtnritikic Aal. Care, with a placebo, but less than that reported in previous analyses. Beer Sheva, Israel Background and Goals of Study: Subarachnoid hemorrhage (SAH) is as- sociated with significant morbidity and mortality. Glutamate scavengers have been shown to decrease glutamate concentrations in the blood and improve neurological outcome following ischemic stroke and traumatic brain injury in rats. This study examines the value of blood glutamate scavengers, pyruvate and oxaloacetate, as a therapeutic neuroprotective strategy in a rat model of SAH. WMaet eardidailtsio annaldly Minevtehsotidgsa:t ed whether glutamate scavenging was the mecha- nism responsible for any resulting neuroprotection. SAH was induced in 60 rats by autologous arte- rial blood injection into the cisterna magnum. 20 additional rats served as the sham group, with a 0.3 ml saline injection into the cisterna magnum. 60 minutes later, rats were treated with isotonic saline, 250 mg/kg oxaloacetate, or 125 mg/kg pyruvate by intravenous infusion for 30 minutes at a rate of 0.1 ml/100g/min. Prior to the induction of SAH (baseline) and 90 minutes after SAH, blood samples were collected. Rats’ neurological status was measured 24 hours following SAH. Glutamate concentrations in the CSF of half of the [Figure 1] rats were also measured 24 hours following SAH. The blood brain barrier (RBeBsBu)l tps earmnde aDbiilsitcyu isns tihoen :p arieto-occipital and frontal lobes was assessed in the remaining half via histological analysis 48 hours following SAH. Blood glutamate levels were decreased in rats treated with pyruvate or oxaloacetate at 90 minutes following SAH (p < 0.001). CSF glutamate was decreased in rats treated with pyruvate (p< 0.05). Neurological performance improved significantly in rats treated with pyruvate (p< 0.01) or oxaloacetate (p< 0.05). There was less BBB breakdown in the pCaorniectlou-soicocnipsi:t al lobes in rats treated with oxaloacetate (p< 0.01) or pyruvate (p< 0.01), and in the frontal lobe in rats treated with pyruvate (p< 0.05). This study suggests the effectiveness of blood glutamate scav- engers, pyruvate and oxaloacetate, in the treatment of SAH in rats. The data sAucgkgneoswtsle thdagte tmhee onbtss:e rved neuroprotection with treatment of pyruvate or oxa- loacetate is mediated via their blood glutamate scavenging effect. This work was supported by the grant awarded to Alexander Zlotnik MD, PhD from the European Society of Anesthesiologists in 2010. ESAPC1-2 Re-evaluation of the effectiveness of ramosetron in preventing post-operative nausea and vomiting: a meta-analysis without Fujii et al.’s RCTs [Figure 2] Yokohama City University School of Medicine, Dept of Anaesthesiology & MIntiheanrsaiv Te. ,C Taorjoe ,K Y.o, kGoohtaom Ta., Japan ESAPC1-3 Background: Drug interaction models are better predictors of tolerance/ 5-hydroxy-tryptamine receptor 3 antagonists (e.g. ramosetron) response to noxious stimuli compared to individual measured are used to prevent post-operative nausea and vomiting (PONV). Ramosetron parameters has been shown to have a very strong effect (Relative Risk = 0.3) in prevent- ing PONV in previous meta-analyses. However, these previous meta-analyses included a number of studies by Fujii et al. which have now been proven HUnainvneirvsoitoyr ot fL G.Nr.o, nPinrogoesnt, JU.Hni.v, eErsleitvye lMd eDd.Jic.,a Sl Ctreunytse Mr G.Mro.Rn.inF.,g Leung, iDnebpüth ol fM ., to have been fabricated. We believe that the conclusion will change if ramo- VAenraeeescthkees Hio.lEo.gMy., Groningen, Netherlands setron is re-evaluated without Fujii et al.’s studies. The aim of the present mMeettah-oadnsa:ly sis was to re-evaluate the effectiveness of ramosetron in prevent- Background and Goal of Study: ing PONV after excluding Fujii et al.’s randomized controlled trials (RCTs). We searched MEDLINE, CENTRAL, Embase, and Web of Science. This study continues the pursuit of the pa- All double-blind RCTs that tested the efficacy of ramosetron compared rameter with the best correlation to the probability of response to noxious with a placebo in the prophylaxis of PONV were considered to be eligible. stimu1li of different intensity. We used data from a previous study by Heyse Dichotomous data were summarized using risk ratio (RR) 2with a 95% confi- Met aatle.r ioanls thaen din Mteerathctoiodns :o f sevoflurane and remifentanil to compare several dence interval (CI). Heterogeneity was quantified with the I statistic. parameters. PRuebsluicltast:io n bias was assessed using a funnel plot and Egger’s regression After institutional review board approval, 40 adult asymmetry test. patients were randomised to receive different combinations of sevoflurane A total of 734 patients were included in the final analysis. In com- (Sevo) and remifentanil (Remi) according to a criss-cross design. After reach- parison with a placebo, ramosetron reduces the incidence of early PON (RR ing pseudo-steady state, the patients were assessed for tolerance of ‘shake [95%CI] 0.59 [0.47, 0.73]), late PON (RR 0.65 [0.49, 0.85]; Figure 1), early and shout’ (SAS), tetanic stimulation (TET), insertion of laryngeal mask airway 2 ESA Best Abstract Prize Competition (BAPC) (LMA) and laryngoscopy (LAR). Bispectral index (BIS), state and response en- tRioenfe arnexniecteys,: eating disturbances and aggression against authority estimated tropy (SE, RE), composite variability index (CVI) and surgical pleth index (SPI) by results of PHBQ. were either recorded or computed from raw electroencephalographic and plethysmographic data retrospectively. Sevo and Remi concentrations were 1. Kain ZN et al. Anesth Analg 2004;99:1648. recorded. The combined potency of Sevo and Remi according to the fixed 2. Karling M et al. Acta Paediatr 2006;95:340. C50O hierarchical interaction model (U) and the noxious stimulation response ESAPC1-5 index (NSRI) were the population-based predictors. We used the prediction Genetic factors contribute to enhanced fibrinolytic activity in probability (PK) to assess the performance of these parameters on the prob- patients undergoing cardiac surgery ability of response. Bootstrapping (n=1000) was used to produce 84%-confi- Rdeenscuelt sin taenrvda lDs isocf uthses iPoKns:, with significance being achieved if the confidence Pauls Stradins Clinical University Hospital, Dept of Anaesthesiology & intervals did not overlap (p < 0.05). The parameter PKs per stimulus are summarised OInzteonlisniave A C., aSrter,ik Rei gEa.,, JLaautvniaalksne I., Nikitina Zake L., Harlamovs V., Vanags I. in Table 1. U NSRI Sevo Remi BIS SE RE CVI SPI Background and Goal of Study: SAS TET 96% 96% 89% * 60% * 95% 93% 93% 92% 57% * Low plasma levels of plasminogen activator LMA 96% 94% 79% * 69% * 84% * 84% * 84% * 83% * 53% * inhibitor -1 (PAI-1) and tissue plasminogen activator/PAI-1 (t-PA/PAI-1) complex are associated with enhanced fibrinolysis. The Renin Angiotensin Aldosteron LAR 98% 95% 81% * 63% * 83% * 81% * 81% * 79% * 57% * system (RAAS) regulates the fibrinolysis. Angiotensin IV and Aldosteron trig- [Table 1. P9a8r%amete95r %pred7ic6t%io *n pr7o2b%a *bilit7ie8s%] * 78% * 77% * 74% * 58% * ger the generation of PAI-1 whereas Bradykinin stimulates secretion of t-PA. Recent studies indicate that genetic factors determine the plasma levels of PAI-1 and t-PA/PAI-1, influencing blood loss after surgery employing cardio- * p < 0.05, compared to U and NSRI pulmonary bypass (CPB). The goal: To investigate the potential effects of PAI-1 4G/5G and 844 A/G gene The PK for U and NSRI were highest for all stimuli. Effect site concentrations of polymorphisms and Angiotensin converting enzyme (ACE) intron 16 I/D gene either Sevo or Remi alone were significantly worse predictors. BIS, SE, RE and pMoelythmoodrsp:h ism on fibrinolytic activity in patients after cardiac surgery with CCVoIn wcleursei osing:n ificantly worse at predicting tolerance to the three painful stimuli, CPB. but similar to U and NSRI for SAS. SPI performed poorly overall. After ethical approval, 90 patients were studied prospectively, U and NSRI perform significantly better than EEG-derived pa- whereof 7 were excluded because of surgical bleeding. In 83 patients, PAI-1 rameters and single drug effect site concentrations in predicting tolerance gene 4G/5G and 844 A/G, and ACE intron 16 I/D polymorphisms were ana- tRoe nfeorxeionucse ss:ti muli. Therefore both U and NSRI could be useful parameters in lyzed. To asses fibrinolysis, PAI-1 and t-PA/PAI-1 complex were determined anaesthetic practice. preoperatively and 24 h postoperatively, respectively, and D-dimer at 0 h, 6 h and 24 h after surgery. Postoperative accumulated 24 h bleeding volume was 1. Heyse B, Proost JH, Schumacher PM, et al. Anesthesiology 2012;116:311-23. registered. Associations between 24 h blood loss, genetic polymorphisms, ESAPC1-4 pRaersaumltest:e rs of fibrinolysis were analyzed separately for each polymorphism Does total intravenous anesthesia decrease postoperative using SPSS 18. behavioral changes after adenotonsillectomy in children? The following genotypes were detected: PAI-1 gene 4G/5G, 4G/4G, 5G/5G, PAI-1 844 A/A, A/G, G/G and ACE intron16 I/I, I/D, D/D genotypes. The lowest PAI-1 levels preoperatively were associated with PAI-1 5G/5G (17±11 SUtnoivjaenrsoivtiyc H Sotisppicit aSl .S, pKlaitr,d Duemp tG o.f, ACnaareesv thMe.,s iRoolojeg yZ &., MInitleannsoivviec CLaitrree ,D S.,p lit, ng/ml), PAI-1 844 G/G (18±12 ng/ml) and ACE intro 16 I/I (18±11 ng/ml) gen- EClreozaotivaic N. otype groups. The t-PA/PAI-1 complex reached the lowest level in the ACE intron 16 I/I carriers (2.8±2 ng/ml). 24-hour blood loss differed significantly between PAI-1 4G/4G and 5G/5G Background and Goal of Study: (432±168 vs 568±192 ml; p=0.02), PAI-1 4G/4G and 4G/5G (432±168 vs Postoperative behavioral changes (PBC) 609±321 ml; p=0.02) and PAI-1 844 G/G and A/A carriers (601±221 vs occur in up to 50% of children undergoing surgery and general anesthesia. 436±266 ml; p=0.03). 24-hour blood loss in the ACE intron16 gene genotype They include general anxiety, sleep disorders, enuresis and temper tantrums; groups did not differ significantly. if PBC persist, the emotional and cognitive development may be significantly PAI-1 5G/5G carriers displayed the highest D-dimer levels at 6, 24 h after sur- affected (1). Total intravenous anesthesia (TIVA) is increasingly used in routine gCeornyc alunsdi oPnAsI-:1 844 G/G carriers at 24 h. Within the ACE intron16 I/D groups, pediatric anesthesia. The aim of this study was to assess whether the choice D-dimer did not differ significantly. oMf adteifrfiearlesn at nadn eMseththetoicd ste: chniques for adenotonsillectomy may impact upon Enhanced fibrinolysis may be associated with PAI-1 gene the incidence of PBC in repeated measurements. 5G/5G, 844 G/G and ACE Intron 16 I/I genotypes which can influence the The children (n=36), age 6-12 yrs, were randomized blood loss. ESAPC1-6 into 2 groups: TIVA (n=18) and sevoflurane (S) (n=18). After applying EMLA cream, all patients had iv line before the induction and were given midazolam Safety of epidural and spinal regional anesthesia in 0.05 µg/kg. In TIVA group anesthesia was induced with propofol, fentanyl over 100,000 consecutive major lower extremity joint and vecuronium,and maintained with continuous infusion of propofol. In S replacements - a case series group, after fentanyl 1 µg/kg anesthesia was induced and maintained with sevoflurane in O2/N20 (50:50) mixture. BIS monitoring was used and depth of anesthesia accordingly adjusted. All patients were given paracetamol PHuomspbitearlg foerr MSp.,e Mcieaml Stsuorguedrisy ,S W.Ge.il,l SMtuenddicnael rC Oo.l,l eHgeer zoof gC Ror.n, Belol eUtntniveerr sF.i,t y, 15 mg/kg and dexamethasone 0.2 mg/kg. PBC were evaluated with Post HDeupgahretsm Ae.nP.ts of Anesthesiology and Orthopedic Surgery, New York, United Hospitalization Behavior Questionnaire (PHBQ), consisting of 27 items de- States scribing 6 subscales: General Anxiety, Separation Anxiety, Sleep Anxiety, Eating Disturbances, Aggression Against Authority and Apathy/Withdrawal Background and Goal of Study: (2). PHBQ was fulfilled by parents at days 1,3,7 and 15, as well as 6 months aRfetesru lstus rgaenryd. TDheis cduastas iwoner: e statistically analyzed with repeated measures A feared complication of spinal or epidural ANOVA. anesthesia is the development of epi- or intradural hematomas with subse- Regarding the Separation Anxiety, Eating quent neural element compression. Most data available are derived form the Disturbances and Aggression Against Authority subscales, there were sig- obstetric literature. However, little is known on the frequency of its occurrence nificant differences between TIVA and S group (P< 0.05) in all repeated in the orthopedic joint arthroplasty population, which is usually elderly and measurements, with greater mean values of PBC in S group. Regarding the suffers from significant comorbid burden. We sought to study the incidence General Anxiety, Sleep Anxiety and Apathy/Withdrawal subscales, there were oMf actleinriicaalsll ya snigdn Mifiecathnot dless:i ons after spinal and epidural anesthesia and further no significant differences either in repeated measurements within groups, or describe their nature. bCeotnwceluesni oTnIV:A and S group, although higher mean values of PBC were re- We analyzed charts of all patients who underwent corded in group S (P>0.05). THA or TKA under neuraxial anesthesia at our institution between January The choice of anesthetic technique could affect PBC. Children 2000 and October 2010. Patients with radiographically confirmed epidural le- anesthetized with TIVA for adenotonsillectomy had significantly less separa- sions were identified and further analyzed.
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