Epidurals in Pancreatic Resection Outcomes (E-PRO) study: protocol for a randomised controlled trial.

INTRODUCTION: Epidural analgesia provides an important synergistic method of pain control. In addition to reducing perioperative opioid consumption, the deliverance of analgesia into the epidural space, effectively creating a sympathetic blockade, has a multitude of additional potential benefits, from decreasing the incidence of postoperative delirium to reducing the development of persistent postsurgical pain (PPSP). Prior studies have also identified a correlation between the use of epidural analgesia and improved oncological outcomes and survival. The aim of this study is to evaluate the effect of epidural analgesia in pancreatic operations on immediate postoperative outcomes, the development of PPSP and oncological outcomes in a prospective, single-blind, randomised controlled trial. METHODS: The Epidurals in Pancreatic Resection Outcomes (E-PRO) study is a prospective, single-centre, randomised controlled trial. 150 patients undergoing either pancreaticoduodenectomy or distal pancreatectomy will be randomised to receive an epidural bupivacaine infusion following anaesthetic induction followed by continued epidural bupivacaine infusion postoperatively in addition to the institutional standardised pain regimen of hydromorphone patient-controlled analgesia (PCA), acetaminophen and ketorolac (intervention group) or no epidural infusion and only the standardised postoperative pain regimen (control group). The primary outcome was the postoperative opioid consumption, measured in morphine or morphine-equivalents. Secondary outcomes include patient-reported postoperative pain numerical rating scores, trend and relative ratios of serum inflammatory markers (interleukin (IL)-1ß, IL-6, tumour necrosis factor-α, IL-10), occurrence of postoperative delirium, development of PPSP as determined by quantitative sensory testing, and disease-free and overall survival. ETHICS AND DISSEMINATION: The E-PRO trial has been approved by the institutional review board. Recruitment began in May 2016 and will continue until the end of May 2018. Dissemination plans include presentations at scientific conferences and scientific publications. TRIAL REGISTRATION NUMBER: NCT02681796.

Time-resolved fluorescence spectroscopy of two-photon laser-excited 8p, 9p, 5f, and 6f levels in neutral xenon.

Laser-induced fluorescence of two-photon excited 8p, 9p, J=0, 2 and 5f, 6f, J=2 levels in neutral xenon has been investigated in the pressure regime between 4 and 120 Pa. Radiative lifetimes and collisional deactivation rates have been deduced especially for the 5f[3/2](2), 5f[5/2](2), and 8p[1/2](0) levels using the Stern-Volmer approach. The spontaneous lifetimes for 5f[3/2](2), 5f[5/2](2), and 8p[1/2](0) levels are 94, 78, and 207 ns, respectively. These lifetimes have been calculated also by applying extended multiconfiguration Dirac-Fock wave functions and are found in agreement with experiment within 10-25 %.

Oxygen plasma flow properties deduced from laser-induced fluorescence and probe measurements.

Estimation of the local dissociation degree and the local mass-specific enthalpy of a pure oxygen plasma flow determined mainly from laser-induced fluorescence measurements are reported. Measurements have been conducted for several generator parameters in an inductively heated plasma wind tunnel. Additional probe measurements of total pressure together with the deduced translational temperature are used to estimate the local mass-specific enthalpy. For a reference condition, full dissociation has been measured. The measured translational temperature of atomic oxygen for this condition is T = 3500 K. Subsequently, the local mass-specific enthalpy has been derived using these local density and temperature measurements. For the reference condition the estimated value of h = 27 MJ/kg is in good agreement with the probe measurements and results from diode laser absorption spectroscopy.