Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Aug 1980
Comparative StudyComparison of Glycopyrrolate, atropine and hyoscine in mixture with neostigmine for reversal of neuromuscular block following closed mitral valvotomy.
Atropine, glycopyrrolate and hyoscine were compared in a mixture with neostigmine for the reversal of neuromuscular block in patients undergoing closed mitral valvotomy. Both atropine and glycopyrrolate were effective in counteracting the muscarinic effects of neostigmine. ⋯ The control of secretions was better with glycopyrrolate. Administration of hyoscine was associated with unacceptable falls in heart rate and is not recommended.
-
Acta Anaesthesiol Scand · Aug 1980
Randomized Controlled Trial Comparative Study Clinical TrialEpidural versus general anaesthesia for total hip arthroplasty in elderly patients.
Sixty elderly patients were given at random either epidural analgesia with bupivacaine 0.75% or general anaesthesia with thiopentone, fentanyl, pancuronium, N2O/O2 for total hip replacement. Preoperatively the patients were of equal physical status with normal and similar laboratory values. All patients were mentally normal for their age. ⋯ Two patients in the epidural group had symptoms of pulmonary embolism postoperatively. Thus elderly patients appear to do better after hip replacement with less deterioration of cerebral and pulmonary functions when given epidural analgesia than when surgery is performed under general anaesthesia. These patients should therefore be offered epidural analgesia whenever possible.
-
Acta Anaesthesiol Scand · Aug 1980
Effects of the level of CPAP on central haemodynamics and oxygen transport.
The effects of different levels of continuous positive airway pressure (CPAP) on central haemodynamics and oxygen transport were studied in ten spontaneously breathing male patients who had undergone aortocoronary bypass graft operation 18 h earlier. With increasing CPAP levels ranging from 5 cmH2O(0.49kPa)(CPAP 5) to 15 cmH2O(1.47kPa)(CPAP 15), the cardiac index was found to decrease significantly, while the intraluminal pulmonary capillary wedge and right atrial pressures increased simultaneously. The mean systemic arterial pressure remained unaltered, while the mean pulmonary arterial pressure increased with increasing CPAP. ⋯ Thus, low level CPAP might be beneficial in maintaining proper lung volume in an intubated patient after aortocoronary bypass surgery. The observations also suggest that, in these patients, CPAP levels exceeding 10 cmH2O bring about cardiac depression leading to an undesirable reduction in systemic oxygen transport. Mixed venous blood oxygen tension may offer information useful in the adjustment of the level of CPAP.
-
Acta Anaesthesiol Scand · Aug 1980
Comparative StudyEffect of epidural versus general anaesthesia on calf blood flow.
The arterial inflow into the calf, venous emptying rate and venous capacity were studied by means of venous occlusion plethysmography on the non-operated leg in two groups of patients undergoing total hip replacement. One group of eight patients received epidural blockade intraoperatively, which was prolonged postoperatively for pain relief, while the other group of eight patients was given general anaesthesia with intermittent positive-pressure ventilation intraoperatively and parenteral analgesics for pain relief in the postoperative period. ⋯ The sustained reduction of flow in the deep veins of the lower limb might be a significant contributory factor in the initiation of deep venous thrombosis. In three of the eight patients in the general anaesthesia group, the venous emptying rate and venous capacity had decreased 3 h postoperatively to a very low level, indicating thrombus formation in immediate association with the surgery.