Ugeskrift for laeger
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Ugeskrift for laeger · Apr 1993
Case Reports[Pulmonary edema during terbutaline infusion against threatened premature labor].
A case of pulmonary oedema during tocolytic therapy with terbutaline infusion is reported. Although a cardiogenic cause for this type of pulmonary oedema has never been proven, it is believed that physiologic changes in pregnancy aggravated by beta-2 stimulation together with fluid overload constitute the pathophysiologic background to this serious complication.
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Ugeskrift for laeger · Apr 1993
Comparative Study[Complications of spinal anesthesia compared to general anesthesia. A prospective study of 408 consecutive orthopedic patients].
In this prospective study the preoperative risk classification and pulmonary status was compared to postoperative mortality and morbidity, following either spinal or general anaesthesia. We studied 408 consecutive orthopaedic patients. Comparing the anaesthetic methods we found no differences in mortality or in frequency of cardiac complications, while the non-cardiac complications were seen more frequently in patients who had undergone spinal anaesthesia (p < 0.05). Patients from the lower risk groups with a preoperative abnormal pulmonary status had a higher frequency of postoperative pulmonary complications following spinal anaesthesia than following general anaesthesia (p = 0.015). ⋯ 1) We find no difference in postoperative mortality depending on the anaesthetic method chosen, 2) the predictive value of the Boston Cardiac Risk index is identical for the two anaesthetic methods, and 3) the anaesthetic method of choice for the pulmonary disabled patient has not yet been established.
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Ugeskrift for laeger · Apr 1993
Case Reports[Prevention of aspiration in obstetric patients in Denmark].
Women about to undergo Caesarean section are especially prone to suffer from aspiration of acid gastric contents into the lungs during anaesthesia. Physiological changes in the pregnant patient make gastric emptying time unpredictable. ⋯ This survey reveals that 25% of the obstetric-anaesthesiological departments in Denmark employ pharmacological prophylaxis for aspiration of acid gastric contents. This finding is in contrast to a similar survey in the United Kingdom, where 99 to 100% of the Caesarean sections are carried out under pharmacological prophylaxis for aspiration of acid gastric contents.
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Ugeskrift for laeger · Apr 1993
[Paraclinical examination programs in Danish hospitals prior to minor surgical procedures].
Using a questionnaire, paraclinical test programs prior to minor surgery were recorded for Danish hospitals. Sixty-one out of 66 departments of surgery completed the questionnaire. Most of the departments used a basic test program for younger subjects and an extended one for elderly subjects. ⋯ The number of tests ranged from zero to nine (median three) for younger patients and from two to ten (median six) for elderly subjects. The estimated costs of the programs ranged from zero to 1092 Danish crowns (109 pounds) (median 185) for younger patients and from 71 to 1676 Danish crowns (167 pounds) (median 714) for elderly patients. In conclusion, the variation in the extent and estimated costs of preoperative test programs used in Danish hospitals is considerable.