Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 1983
Comparative Study Clinical Trial Controlled Clinical TrialTranscutaneous PO2 monitoring during treatment with continuous positive airway pressure in infants with idiopathic respiratory distress syndrome.
During a 20-month period, 20 infants with idiopathic respiratory distress syndrome (IRDS) were treated with continuous positive airway pressure (CPAP) when they required at least 40% inspired oxygen. The infants were allocated to monitoring with either repeated blood-gas determinations according to the usual practice or continuous transcutaneous PO2 measurements supplemented by blood-gas measurements only when judged necessary. ⋯ However, PtcO2 monitoring resulted in significantly less hypo- and hyperoxaemia and the number of blood-gas analyses performed during CPAP therapy amounted to only 0.6 per infant per day in the transcutaneously monitored group as against 5.3 in the other group. We propose that PtcO2 monitoring should now be the method of choice and that the use of umbilical artery catheterization should be restricted to selected groups of very low birth-weight infants and to infants in need of ventilator therapy.
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Acta Anaesthesiol Scand · Feb 1983
Comparative StudyCardiac arrhythmias in non-intubated children during adenoidectomy. A comparison between enflurane and halothane anaesthesia.
The incidence of cardiac arrhythmias, heart rate, blood pressure, capillary perfusion and end-tidal CO2 tension were studied in 167 healthy children 1-12 years of age undergoing adenoidectomy (n = 82) and myringotomy (n = 85) during enflurane and halothane anaesthesia. The incidence of cardiac arrhythmias was significantly lower during myringotomy than during adenoidectomy. In children undergoing adenoidectomy the incidence of arrhythmias was 38.9% during enflurane anaesthesia and 86.6% during halothane anaesthesia (P less than 0.001). ⋯ Heart rate was increased by about 40% at the onset of ventricular arrhythmias. The heart rate remained unchanged with enflurane anaesthesia during surgery, which may reflect a decreased sympathomimetic activity. It is suggested that the low incidence of ventricular arrhythmias during enflurane anaesthesia may be explained by the combination of a reduced sympathomimetic activity and a lowered susceptibility of the myocardium to the actions of endogenous catecholamines.
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Acta Anaesthesiol Scand · Feb 1983
Case ReportsBupivacaine cardiotoxicity in a patient with renal failure.
Bradycardia and hypotension were the first major signs of toxicity from a 250 mg bupivacaine axillary brachial plexus block experienced by a patient with chronic renal failure, who had an anion gap acidosis and hyperkalaemia. Without these metabolic abnormalities, this patient received four similar blocks: three were without incident and one was complicated by seizure. Acidosis and/or hyperkalaemia in man appears to increase the myocardial susceptibility to bupivacaine toxicity into the range of arterial concentrations of the drug normally produced by plexus blocks, even in the absence of drug-induced cerebral toxicity, seizures and hypoxia.