Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 1984
Comparative StudyDiazepam does not prevent succinylcholine-induced fasciculations and myalgia. A comparative evaluation of the effect of diazepam and d-tubocurarine pretreatments.
To determine the effectiveness of diazepam pretreatment in preventing succinylcholine (SCh)-induced fasciculations and body pains, 587 patients were randomly allocated to six groups. Patients in Group I received no pretreatment and served as controls. Patients in Groups II and III were pretreated with 0.05 mg/kg of diazepam either 4-5 min (Group II) or 8-10 min (Group III) prior to SCh administration. ⋯ There was no statistically significant difference in the incidence of body pains by virtue of site of operation, age, sex, and inpatient/outpatient status. It is concluded that the problem of postoperative myalgia is significant and that dTc pretreatment is the effective method for prevention of fasciculations and postoperative myalgia. Diazepam pretreatment was ineffective for the prevention of fasciculations and myalgia.
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Heat loss during anesthesia and operation and subsequent hypothermia will increase the postoperative oxygen demand and may endanger patients with restricted cardiopulmonary reserves. Forty patients scheduled for intra-abdominal aortic surgery and 40 patients scheduled for peripheral vascular surgery on the lower limbs were investigated using a warming blanket, humidified heated inspired anesthetic gases at 37-40 degrees C, or both these methods together. A fourth group of patients received no active warming. ⋯ The combination of humidified and heated inspired gases and a warming blanket gave significantly better heat preservation after 40 min (P less than 0.05). Patients undergoing peripheral vascular surgery had similar but smaller drops in temperature with the different types of warming procedures employed. The differences in temperature between the intra-abdominal and extra-abdominal operations were statistically significant after 3 h (P less than 0.05).
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Acta Anaesthesiol Scand · Oct 1984
Laryngospasm during anaesthesia. A computer-aided incidence study in 136,929 patients.
With the aid of a computerized anaesthetic record-keeping system, the incidence of laryngospasm during anaesthesia was studied, in order to quantify the risk of this complication. 136,929 patients given 156,064 anaesthetics were studied. There were 1,232 cases of laryngospasm recorded in 1,197 patients. The incidence of laryngospasm was calculated in subgroups characterized by age, sex, preanaesthetic conditions, premedication, anaesthetic technique, type of surgery and concomitant complication. ⋯ Figures exceeding 25 laryngospasms in 1,000 patients were seen in the age group 1-3 months and in children undergoing appendicectomy, oral endoscopy and plastic surgery, when tracheal intubation had been performed and when a gastrointestinal tube was used. In the age group 50-59 years, an incidence exceeding 25 in 1,000 patients was seen when there had been preoperative airway obstruction and in females when the anaesthetic technique included spontaneous breathing and face mask, or apneic oxygenation. Dilatation of the anal sphincter and mediastinoscopy in males were also associated with an increased incidence of laryngospasm.
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Acta Anaesthesiol Scand · Oct 1984
Randomized Controlled Trial Clinical TrialHypotensive anesthesia, thromboprophylaxis and postoperative thromboembolism in total hip arthroplasty.
A prospective study was performed in 120 patients undergoing total hip arthroplasty. The patients were randomly allocated to four groups. The first two groups had nitroprusside-induced hypotensive anesthesia with either a fixed combination of sodium heparin and dihydroergotamine mesylate (HDHE) or dextran 70. ⋯ There was a lower incidence of pulmonary embolism in patients with HDHE and normotensive anesthesia. Major wound hematomas were noted postoperatively in 12% of the patients receiving HDHE, whereas no major hematomas developed following dextran prophylaxis. No anaphylactic reaction was noted from dextran 70, using hapten-dextran prophylaxis.
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Acta Anaesthesiol Scand · Oct 1984
Lateral positioning with differential lung ventilation and unilateral PEEP following unilateral acid aspiration in the dog.
Body position can significantly alter the efficiency of gas exchange following unilateral lung injury. We systematically examined three positions during differential lung ventilation with unilateral positive end-expiratory pressure (PEEP) following unilateral hydrochloric acid aspiration in the dog. Twelve mongrel dogs were intubated with a double-lumen endobronchial tube and mechanically ventilated with a microcomputer-controlled pair of ventilators. ⋯ There was no significant difference between the three positions with regard to PaO2 (F (2, 10) = 1.60, P = 0.25) of venous admixture (F (2, 10) = 0.49, P = 0.63). Our data indicated that position did not alter oxygenation. This was probably due to the use of differential ventilation with unilateral PEEP which eliminated redistribution of ventilation between the two lungs and minimized position-dependent changes in pulmonary blood flow.