Ugeskrift for laeger
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The larynx mask (LM) is an alternative to a mask and endotracheal tube. LM ensures free airway for the patient under anaesthesia while the anaesthetist has his hands free. ⋯ The literature is reviewed. The possibilities for employment are discussed and the authors' personal experience is presented.
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Ugeskrift for laeger · May 1992
Randomized Controlled Trial Clinical Trial[Continuous positive airway pressure (CPAP)--does the equipment live up to its name?].
The purpose of this study was to evaluate the in- and expiratory pressures achieved by the use of different continuous positive airway pressure (CPAP) delivery systems. The study was performed on ten healthy adults breathing spontaneously with: 1) "simple CPAP", consisting of a fresh gas flow around 40 l/min and reservoir balloons of 2, 6 and 10 l and expiration against a water column, 2) a high-flow system CR60 CPAP, designed for home treatment and 3) another high-flow system Down's CPAP. Both high-flow systems used a venturi device (Downs Flow Generator, Vital Signs) giving flows around 90 and 170 l/min in our set-up, and the same PEEP valves (Vital signs) were used. ⋯ The high-flow systems were not found to provide better CPAP, however, CR60 CPAP was found also to be optimal with 5 and 10 cm H2O. Down's CPAP provided 3-5 cm higher expiratory pressure than the intended CPAP level. We recommend measurement of the pressure during the CPAP treatment to ensure that the intended CPAP is achieved.
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Ugeskrift for laeger · May 1992
[Guanethidine blockade for palliative treatment in reflex dystrophy].
Guanethidine blockade was employed in 22 patients with causalgia, hyperpathia and reflex dystrophy in an upper limb. Guanethidine was administered by means of regional intravenous technique in which 20 mg guanethidine was mixed with 400 IU of heparin and 70 mg lignocaine. ⋯ In 68% of the patients, beneficial results occurred as they were relieved of pain or improved considerably. Employment of lignocaine in the injection solution made the blockade less painful.
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Alcoholic ketoacidosis is seen in chronic alcoholics who have been starving for days. This was the case in the present patient who had metabolic acidosis on admission. The differential diagnoses are primarily diabetic ketoacidosis, intoxication (salicylate, methanol, ethylene glycol and fenformin), lactate acidosis, hunger-induced ketoacidosis and uraemia. Treatment should consist of intravenous glucose and correction of the dehydration with isotonic sodium chloride.
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Ugeskrift for laeger · Apr 1992
[Cost-benefit analysis of electric stimulation of the spinal cord in the treatment of angina pectoris].
Since August 1988, in Odense Hospital, electric spinal cord stimulation (SCS) has been employed for the treatment of pain in patients with confirmed ischaemic heart disease who suffer from incapacitating angina pectoris despite maximal medical/surgical treatment. The object of the present investigation was to assess not only the social economic consequences of SCS treatment (cost-utility analysis) but also altered quality of life in SCS patients (perception of pain, mobility, function in daily life and physical activity). Sixteen consecutive SCS patients all of whom were resident in the County of Funen and who were submitted to implantation of an SCS system during the period August 1988 to December 1989, participated in this investigation. ⋯ Saving was found at hospital level (reduction in number of admissions) og 40,200 Danish crowns/annum/patient (approximately IJ 3,000) (1989 prices), and for non-hospital related expenses a corresponding saving of 16,289 Danish crowns/annum/patient (approximately IJ 1,600) was found mainly on account of reduction in the amount of home nursing required. The total saving was found to constitute 56,489 Danish crowns/annum/patient (approximately IJ 5,600). In addition, improvements were registered in all respects which constituted assessment of the quality of life of the patients.