Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 1985
Epidural morphine for postoperative pain: experience with 1085 patients.
A prospective study of the effect and side-effects of epidural morphine for pain relief in 1085 patients after thoracic, abdominal, urologic, or orthopaedic surgery was performed. Morphine chloride was diluted in saline or bupivacaine and administered through an epidural catheter placed at a segmental level appropriate for the type of surgery. The initial dose was 4 or 6 mg morphine and supplementary doses were given when needed to obtain complete freedom from pain during deep breathing or nursing care. ⋯ Postoperative nausea or vomiting was more frequent in women than in men (P less than 0.001). There was a higher incidence of nausea or vomiting in men experiencing pain than in men who were completely pain-free after abdominal surgery (P less than 0.001). Respiratory depression was rare and occurred as a gradually decreasing respiratory rate.(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · Jan 1985
Development and evaluation of a flow-dividing unit for differential ventilation and selective PEEP.
Differential ventilation with selective positive end-expiratory pressure (PEEP) was studied in a two-compartment lung model, using one ventilator and a flow-dividing unit consisting of inspiratory flow resistors and an inspiratory threshold valve. The compliance of each lung compartment was varied between 0.15 and 0.23 1 X kPa-1 and the resistance was varied from 0 to 3.5 kPa X 1(-1) X s. The minute volume was 12 1 and the respiratory frequency 12/min, with an inspiratory:expiratory ratio of 1:2. ⋯ Large differences in the inspiratory impedance of the two lung compartments caused asynchronous gas delivery when the ventilation distribution was adjusted by means of the flow resistors. Use of the threshold valve resulted in synchronous gas delivery. The flow-dividing unit consists of non-active elements and can thus be connected to any ventilator.
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Acta Anaesthesiol Scand · Jan 1985
Randomized Controlled Trial Comparative Study Clinical TrialEffects of three anaesthesia methods on haemodynamic responses connected with the use of thigh tourniquet in orthopaedic patients.
Haemodynamic changes were studied in 51 patients undergoing orthopaedic surgery of the lower extremity, including exsanguination and thigh tourniquet for longer than 60 min. The patients were randomly divided into three anaesthesia groups: general anaesthesia (including enflurane), epidural anaesthesia (20 ml 0.5% bupivacaine) and spinal anaesthesia (3 ml 0.5% bupivacaine). During the study, five epidural and one spinal patient excluded from haemodynamic comparison required general anaesthesia because of pain from the surgery or ischaemia. ⋯ On the other hand, 11/15 of the epidural patients needed additional analgesics and/or sedation for pain or restlessness. The mean rise in the haemodynamic parameters including CVP was small on inflation of the tourniquet cuff; on deflation there was a mean decrease in CVP of 1-3 cmH2 (0.1-0.3 kPa), the maximum decrease being 8 cmH2O (0.8 kPa). The mean decrease in systolic arterial blood pressure ranged from 2 to 14 mmHg (0.27 to 1.87 kPa) when the cuff was deflated.
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Acta Anaesthesiol Scand · Jan 1985
Historical ArticleThe introduction of ether anaesthesia in the Nordic countries.
The way in which the news about ether anaesthesia went from U. S. A. to Europe is briefly described. ⋯ In Norway, ether was used on 4 March in Christiania (Oslo), and in Finland on 8 March in Helsingfors (Helsinki). Anaesthesia in Iceland cannot be traced any earlier than 1856. A table shows when the first anaesthetics were given in different places in Europe and the world.
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Acta Anaesthesiol Scand · Jan 1985
A method for epiduroscopy and spinaloscopy. Presentation of preliminary results.
A method for endoscopic observation of the epidural space, epiduroscopy, and the subarachnoid space, spinaloscopy, in the lumbar region is described using the Olympus Selfoscope SES 1711 S. The preliminary results of 30 consecutive attempts at epiduroscopy on randomly chosen autopsy cases, with 28 successes, are presented. Five spinaloscopies were performed on the same material. The results justify the conclusion that epiduroscopy and spinaloscopy are methods that can be used for study of individual variation of the contents of the lumbar epidural and subarachnoid spaces.