Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jun 1983
Comparative StudyCapnography for detection of accidental oesophageal intubation.
The clinical diagnostic signs for detecting inadvertent oesophageal intubation may all be misleading. We therefore tested the practice of recording exhaled carbon dioxide during the intubation procedure as an additional measure for detection of accidental oesophageal intubation. Twenty patients were intubated simultaneously into the trachea and oesophagus and the carbon dioxide concentration was continuously recorded from both sources. ⋯ Ventilation by mask prior to the intubation obviously resulted in some filling the stomach by exhaled gas in 9 of the 20 patients. In these cases some CO2 could be detected during oesophageal ventilation. As the oesophageal CO2 concentrations were very low initially, compared to the tracheal recordings, and carbon dioxide completely disappeared after a few ventilations into the oesophagus, distinguishing between the tracheal and oesophageal capnography tracings was easy.
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Acta Anaesthesiol Scand · Jun 1983
A medically staffed emergency ambulance service. Report of a 5-year prospective study.
The results of a prospective 5-year study of a medically staffed ambulance service are presented. There was a total of 558 turn-outs distributed among a mixed patient material. ⋯ In 44 further cases, other relevant forms of emergency treatment were administered. It is concluded that prehospital treatment at the scene of accident seems beneficial to patients with life-threatening conditions.
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Acta Anaesthesiol Scand · Jun 1983
Comparative StudyIntradermal histamine release by 3 muscle relaxants.
The induration and redness caused by intradermal injections of equipotent doses of atracurium, vecuronium and d-tubocurarine were measured in six healthy, male volunteers. Atracurium and d-tubocurarine were almost indistinguishable in their reactions. Vecuronium caused a significantly smaller response than both atracurium and d-tubocurarine. We therefore suggest that of these three drugs, vecuronium may cause the least histamine release and is, perhaps, the drug of choice in patients with a history of asthma or allergy.
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Acta Anaesthesiol Scand · Jun 1983
Sister chromatid exchanges and structural chromosome aberrations in lymphocytes in operating room personnel.
Information on possible chromosomal damage in humans after long-term exposure to trace concentrations of waste anaesthetic gases is scarce. We examined peripheral lymphocytes in operating room personnel for both chromosome aberrations and sister chromatid exchanges (SCE). Following a standardized procedure of cultivation and staining, 30 cells from each person were scored for SCE and 100 cells from each person were examined for chromosome aberrations. ⋯ Examination of SCE and chromosome aberrations yielded corresponding qualitative results. With both tests, no statistically significant difference was observed between the four groups of persons. It was concluded that by examination of both SCE and chromosome aberrations in peripheral lymphocytes in operating room personnel, no indication was found of a mutagenic effect of long-term exposure to trace concentrations of waste anaesthetic gases.
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Acta Anaesthesiol Scand · Jun 1983
Carbon dioxide elimination after acetazolamide in patients with chronic obstructive pulmonary disease and metabolic alkalosis.
Acetazolamide, an inhibitor of carbonic anhydrase, which catalyzes hydration/dehydration of carbon dioxide, has been used for correction of metabolic alkalosis in patients with chronic obstructive pulmonary disease (COPD). Animal experiments have shown that the gradient between tissue and the alveolar CO2 tension increases after inhibition of carbonic anhydrase, suggesting retention of CO2. ⋯ The study showed that there was a statistically significant increase in tissue PCO2 and a temporary decrease in pulmonary carbon dioxide excretion. Furthermore, it was found that PaO2 and PVO2 increased significantly after inhibition of carbonic anhydrase, which could, at least partly, explain the improvement seen in patients with COPD and metabolic alkalosis after treatment with acetazolamide.