Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 1987
Effects of PEEP on extravascular lung water and central blood volume in the dog.
Twenty-four mongrel dogs were anaesthetized and ventilated mechanically in the supine position. Extravascular lung water (EVLW) and central blood volume (CBV) were measured with a double indicator (dye/cold) dilution technique. Both indicators were detected intravascularly in the aortic root with a fibreoptic thermistor catheter. ⋯ It is concluded that EVLWi does not change measurably during ZEEP or short periods of PEEP. However, long periods (8 h) of PEEP result in elevated EVLWi values. Gravimetry supports these conclusions.(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · Nov 1987
Randomized Controlled Trial Clinical Trial Controlled Clinical TrialNo increased incidence of postoperative sore throat after administration of suxamethonium in endotracheal anaesthesia.
Sixty patients were divided into two groups (A and B) of 30 patients each to investigate the effect of using suxamethonium in endotracheal anaesthesia on the incidence of postoperative sore throat. The patients were anaesthetized with thiopentone, fentanyl, droperidol, N2O and pancuronium. ⋯ The type 2 error (beta) was low (the risk of overlooking a "true" difference in incidence of 0.20 was calculated to be 0.04). These results contradict those of a recent study, which demonstrated an increased incidence of postoperative sore throat following the use of suxamethonium in mask anaesthesia.
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Acta Anaesthesiol Scand · Nov 1987
Outcome and costs of intensive care. A follow-up study on patients requiring prolonged mechanical ventilation.
This historically prospective study analysed hospital costs and long-term outcome in 249 consecutive patients who required intensive care including intermittent positive pressure ventilation (IPPV) for 48 h or more. The mean age of the patients was 46.7 years and the mean duration on IPPV was 9.1 days. Mortality in hospital was 43%, increasing to 54.6% five years after admission. ⋯ The cost-benefit ratio, i.e. calculated cost per year of extended life until the age of 75 years, averaged 1420 USD (range 360-7980 USD). With the exception of patients suffering from cancerous diseases, the cost-benefit ratio found in this study was favourable in comparison to other high-cost medical care. This is further emphasized by the fact that for the years saved, the quality of life was mostly good.
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Acta Anaesthesiol Scand · Nov 1987
Randomized Controlled Trial Comparative Study Clinical TrialReduction of pain at venous cannulation in children with a eutectic mixture of lidocaine and prilocaine (EMLA cream): comparison with placebo cream and no local premedication.
The local analgesic efficacy of a cream formulation of lidocaine and prilocaine (EMLA) in reducing pain at venous cannulation was investigated in children scheduled for elective surgery. Forty children participated in a double-blind, randomized comparison between EMLA and inactive placebo cream. Another group of 18 children without any local treatment was studied as an additional control material. ⋯ No significant hormone responses were, however, detected. The lidocaine concentrations measured in venous blood taken from the application site of EMLA cream were low, and there were no measurable levels of lidocaine in simultaneous blood samples from the opposite extremity. In our opinion EMLA cream is safe and alleviates effectively the pain associated with venepuncture, and thus deserves a place in the routine premedication of children.
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Acta Anaesthesiol Scand · Nov 1987
Computerized tomography of the chest and gas exchange measurements during ketamine anaesthesia.
The effects of atelectasis on pulmonary gas exchange were studied in eight supine, clinically lung-healthy patients. Atelectasis was studied by computerized tomography (CT), and gas exchange by blood gas analysis. The distribution of ventilation/perfusion ratios was assessed by a multiple inert gas elimination technique. ⋯ After muscular relaxation and commencement of mechanical ventilation, all patients but one developed both shunt (2-6% of cardiac output) and atelectasis. The shunt correlated to the size of atelectasis. It is concluded that the occurrence of shunt during anaesthesia is related to the development of atelectasis in dependent lung region, which is consistent with the hypothesis that it is changes in chest-wall mechanics that cause atelectasis.