Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 1977
Peripheral nerve injury due to injection needles used for regional anesthesia. An experimental study of the acute effects of needle point trauma.
Nerve injury can arise as a complication peripheral nerve block anesthesia. Of the various factors involved, the trauma caused by the injection needle may be of significance. ⋯ Fascicular injury was indicated by a fluorescence microscopy technique, tracing locally applied Evans Blue Albumin, The results show that a 45 degrees-beveled needle less frequently produces fascicular damage and should therefore be recommended for use in clinical anesthesia. It is also concluded that paresthesiae, when necessary, should be elicited gently, and that intraneural injections should be avoided.
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Acta Anaesthesiol Scand · Jan 1977
Comparative StudyThe cerebrovascular CO2 reactivity during the acute phase of brain injury.
Using the intra-arterial 133xenon (133Xe) method, the cerebrovascular response to acute Paco2 reduction was studied in 26 unconscious, brain-injured patients subjected to controlled ventilation. The CO2 reactivity was calculated as delta in CBF/delta Paco2. The perfusion pressure was defined as the difference between mean arterial pressure and mean intraventricular pressure. ⋯ An increase of the CO2 reactivity with time was observed, indicating normal response after 1-2 weeks. Chronic hypocapnia in six unconscious patients resulted in sustained CSF pH adaptation. The question whether a delay in CSF pH adapation exerts an influence on the CO2 reactivity, and the influence of cerebral lactacidosis on the CO2 response are discussed.
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Acta Anaesthesiol Scand · Jan 1977
Comparative StudyHuman hepatic blood flow and its relation to systemic circulation during intravenous infusion of bupivacaine or etidocaine.
Fifteen healthy young volunteers were studied before and during an intravenous infusion of a local anaesthetic agent. Seven received bupivacaine and eight etidocaine in a dose rate of 2 mg/min over a period of 150 min. Variables of the central systemic circulation and also the hepatic blood flow were measured repeatedly. ⋯ In contrast, these three drugs had the same decreasing effect upon the splanchnic vascular resistance, which caused an almost identical increase in the estimated hepatic blood flow. The calculated vascular resistance in the systemic circulation, excluding the splanchnic, was unchanged during the infusion of etidocaine, while it decreased during the infusion of bupivacaine. Most of this discrepancy was due to the different plasma concentrations of the drugs.
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Acta Anaesthesiol Scand · Jan 1977
Arrhythmias during halothane anaesthesia II: the influence of atropine.
The effect of i.v. atropine premedication on cardiac rhythm was studied in healthy adult patients during thiopental-N2O/O2-halothane anesthesia without intubation. A higher incidnece of arrhythmias was seen in younger patients in close relation to administration of atropine, but the overall incidence during anesthesia was identical in atropine groups and the control groups. ⋯ No consistent changes in blood pressure were observed as the result of arrhythmias or changes in heart rate. It is concluded that atropine should be reserved for situations where severe bradycardia and hypotension occur, or can be expected to occur, and not given automatically, since cardioacceleration which is inherent in its action may be injurious to patients with limited cardiac reserve.
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Acta Anaesthesiol Scand · Jan 1977
Catheter technique in axillary plexus block. Presentation of a new method.
A flexible, disposable intravenous catheter can be introduced into the neuro-vascular sheath in the axilla and used for injection of local anesthetic solution to block the axillary brachial plexus. The technique is described and the results of the first 137 consecutive catheter blocks are reported and compared to a similarly evaluated series of conventional axillary blocks. The catheter method constitutes an interesting alternative to needle techniques and offers the possibility of a continuous axillary block.