A5101840545- Anesthesia and Pain Management
- Anesthesia and Sedative Agents
- Cardiac, Anesthesia and Surgical Outcomes
- Pain Management and Opioid Use
- Nausea and vomiting management
- Ocular Oncology and Treatments
- Multiple Myeloma Research and Treatments
- Immunotherapy and Immune Responses
- Intensive Care Unit Cognitive Disorders
- Total Knee Arthroplasty Outcomes
- Anesthesia and Neurotoxicity Research
- Heart Rate Variability and Autonomic Control
- Pain Mechanisms and Treatments
- Enhanced Recovery After Surgery
- Neuroscience of respiration and sleep
- Blood Coagulation and Thrombosis Mechanisms
- Abdominal Surgery and Complications
- Intraoperative Neuromonitoring and Anesthetic Effects
- Hemodynamic Monitoring and Therapy
- Surgical Simulation and Training
- Atrial Fibrillation Management and Outcomes
- Nicotinic Acetylcholine Receptors Study
- Veterinary Pharmacology and Anesthesia
- Cerebrospinal fluid and hydrocephalus
- Cancer, Stress, Anesthesia, and Immune Response
Leiden University Medical Center
2015-2024
Leiden University
2014-2024
Radboud University Medical Center
2017-2019
Radboud University Nijmegen
2017-2019
Yahoo (United Kingdom)
2019
Committee on Publication Ethics
2019
Novem (Netherlands)
2015
Alessandro Manzoni Hospital
1995
Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone" di Palermo
1995
A novel multidimensional index of nociception, the nociception level (NoL) index, derived from nonlinear composite heart rate (HR), HR variability, amplitude photoplethysmogram, skin conductance, fluctuations in and their time derivatives, was used to assess during anesthesia.Seventy-two American Society Anesthesiologists I III patients received propofol (target bispectral 45) one six remifentanil target concentrations range 0 5 ng/ml. The NoL, mean arterial pressure (MAP; a beat-to-beat...
The majority of postoperative patients report moderate to severe pain, possibly related opioid underdosing or overdosing during surgery. Objective guidance dosing using the Nociception Level (NOL) index, a multiparameter artificial intelligence-driven index designed monitor nociception surgery, may lead more appropriate analgesic regimen, with effects beyond We tested whether NOL-guided general anaesthesia results in less pain.In this two-centre RCT, 50 undergoing abdominal surgery under...
Background It remains unknown whether the administration of a deep neuromuscular block (NMB) during bariatric surgery improves surgical conditions and patient outcome. The authors studied effect versus moderate NMB in laparoscopic on postoperative pain. Methods Results One hundred patients scheduled to undergo elective were randomized (post-tetanic-count 2–3) or (train-of-four 1–2). quality field was scored using Leiden-Surgical Rating Scale (L-SRS), 5-point scale ranging from 1 (extremely...
The multidimensional index of nociception, the nociception level, outperforms blood pressure and heart rate in detection nociceptive events during anesthesia. We hypothesized that level-guided analgesia reduces opioid consumption suboptimal anesthesia such as low use vasoactive medication.In this single-blinded randomized study, 80 American Society Anesthesiologists class I-III adult patients either sex, scheduled for major abdominal procedures under remifentanil/propofol by...
Abstract Background Evidence indicates that low-pressure pneumoperitoneum (PNP) reduces postoperative pain and analgesic consumption. A lower insufflation pressure may hamper visibility working space. The aim of the study is to investigate whether deep neuromuscular blockade (NMB) improves surgical conditions during PNP. Methods This was a blinded randomized controlled multicenter trial. 34 kidney donors scheduled for laparoscopic donor nephrectomy randomly received PNP (6 mmHg) with either...
Abstract Background Treatment of chronic pain conditions is commonly assessed at specific endpoints preset times during or after treatment by analysis the total study population. An alternative approach identification patient subgroups characterized differential response patterns in their analgesic and to determine presence significant predictors effect. Methods Data from four double‐blind, randomized controlled trials on efficacy topical capsaicin 8% ( Q utenza) versus an active control...
Abstract Editor’s Perspective What We Already Know about This Topic Article Tells Us That Is New Background The ventilatory response to hypoxia is a life-saving chemoreflex originating at the carotid bodies that impaired by nondepolarizing neuromuscular blocking agents. study evaluated effect of three strategies for reversal partial block on control in 34 healthy male volunteers chemoreflex. hypothesis was hypoxic fully restored following return train-of-four ratio 1. Methods In this...
Abstract Background While immune checkpoint inhibition (ICI) has revolutionized the treatment of metastatic cutaneous melanoma, no standard treatments are available for patients with uveal melanoma (UM). Several locoregional therapies effective in liver metastases, such as percutaneous hepatic perfusion melphalan (M-PHP). The literature suggests that ICI following UM metastases can result clinical response. We hypothesize combining M-PHP will lead to enhanced antigen presentation and...
Thrombin activatable fibrinolysis inhibitor (TAFI) is an important of fibrinolysis. High TAFI antigen levels are associated with increased risk deep venous thrombosis (DVT). Because partly determined genetically, we assessed the association between three gene polymorphisms (-438 G/A, 505 A/G and 1040 C/T), clot lysis times DVT. Carriers 505G allele, which lower than 505A showed This indicates that relationship more complex previously suggested.
Abstract Purpose Percutaneous hepatic perfusion with melphalan (M-PHP) is a minimally invasive therapy proven efficacy in patients uveal melanoma (UM) liver metastases. M-PHP associated short hospital admission time and limited systemic side effects. In this study, we assessed quality of life (QoL) UM treated M-PHP. Materials Methods A prospective, single-center study including 24 for metastases to the liver. QoL questionnaires were collected at baseline, on day 2/3 after M-PHP, 7 21...
Background Modulatory descending pathways, originating at supraspinal sites that converge dorsal horn neurons, influence pain perception in humans. Defects control are linked to chronic states and its restoration may be a valuable analgesic tool. Conditioned modulation (CPM) is surrogate marker of inhibition reduces the from primary test stimulus during application conditioning stimulus. Here effects analgesics tapentadol, combined mu-opioid receptor agonist noradrenaline reuptake inhibitor,...
In this pooled analysis of two randomized clinical trials, intraoperative opioid dosing based on the nociception level-index produced less pain compared to standard care with a difference in scores post-anesthesia unit 1.5 (95% CI 0.8-2.2) points an 11-point scale. The proportion patients severe was lower by 70%. Severe postoperative remains significant problem and associates several adverse outcomes. Here, we determined whether application monitor that detects nociceptive events, machine...
Profound neuromuscular blockade (NMB) during anaesthesia has been shown to reduce postoperative pain scores, when compared with a moderate block. We hypothesised that profound NMB laparoscopic donor nephrectomy (LDN) could also improve the early quality of recovery after surgery.To compare effectiveness versus LDN in enhancing recovery.A phase IV, double-blinded, randomised controlled trial.Multicentre trial, from November 2016 December 2017.A total 101 living kidney donors scheduled for...
Chronic pain is frequently reported after total hip and knee arthroplasties (THA/TKA) in osteoarthritis (OA) patients. We investigated if severity of acute postoperative following THA/TKA OA patients was associated with during the first year. From an observational study, scheduled for primary (June 2012-December 2017) were included from two hospitals Netherlands. Acute scores collected within 72 h postoperatively categorized as no/mild (NRS ≤ 4) or moderate/severe > 4). Pain assessed...
Recent data shows that a neuromuscular block (NMB) induced by administration of high doses rocuronium improves surgical conditions in certain procedures. However, there are limited on the effect such practices postoperative outcomes. We performed retrospective analysis to compare unplanned 30-day readmissions patients received high-dose versus low-dose during general anesthesia for laparoscopic retroperitoneal surgery. This cohort study was Netherlands an academic hospital where routine NMB...
The use of epidural analgesia (EA) in pancreatic surgery remains under debate. This study compares patients treated with EA versus non-EA after open pancreatectomy a tertiary referral center. All undergoing from 2013 to 2017 were retrospectively reviewed. (Non-)EA was terminated on postoperative day (POD) 3 or earlier if required. In total, 190 (72.5%) received and 72 (27.5%) (mostly intravenous morphine). prematurely 32.6% 10.5% patients. Compared patients, had significantly lower pain...
Abstract Our research group recently published a positive association between early postoperative pain and 30-day complications in broad surgical population. To investigate whether heterogeneity of the population procedures influenced these results, we explored this homogenous A secondary analysis LEOPARD-2 (clinicaltrials.gov NCT02146417) RELAX-1 study (NCT02838134) laparoscopic donor nephrectomy patients (n = 160) was performed. Pain scores on postanesthesia care unit day (POD) 1 2 were...