Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · May 1987
Comparative StudyPostoperative water and electrolyte changes in skeletal muscle: a clinical study with three different intravenous infusions.
Twenty-seven patients admitted for cholecystectomy were matched for age and sex in three groups for different perioperative fluid therapies over a period of 3 days. Group I was given an acetated half-isotone "balanced" saline solution with the addition of 2.5% glucose, Group II an acetated Ringer solution and Group III an isotonic glucose solution. Percutaneous muscle biopsies were performed before and on the third day after surgery for the determination of water content and the concentration of sodium, potassium, magnesium and chloride in skeletal muscle. ⋯ The concentration of sodium and chloride in skeletal muscle increased significantly in Groups II and III, whereas the concentration of potassium decreased in all groups. The cumulative sodium balance was positive in Groups I and II; the potassium balance was negative in all groups. In conclusion, the patients given the balanced saline solution showed the least change in water content and electrolyte concentrations in skeletal muscle.
-
Acta Anaesthesiol Scand · May 1987
Randomized Controlled Trial Clinical TrialEffect of clonidine on haemodynamic responses to endotracheal intubation and on gastric acidity.
Sixty-three patients (ASA 1-2), scheduled for elective surgery under general anaesthesia, were randomly given either oral clonidine (225-375 micrograms) + diazepam (5 15 mg), cimetidine (300 mg the night before and 300 mg in the morning) + diazepam or only diazepam for premedication. Anaesthesia was induced with thiopentone and maintained with N2O + O2 (70:30), enflurane and fentanyl. Vecuronium bromide was used as a muscle relaxant. ⋯ On the electrocardiogram (ECG) during the endotracheal intubation, the incidence of bigeminy was higher in the diazepam patients (5/20) than in the cimetidine patients (2/20) and the clonidine patients (0/23). There were significantly more gastric content samples with a pH above 2.5 in the cimetidine group than in the other groups, and clonidine patients did not differ from diazepam patients in this respect. The high incidence of bradycardia with the concomitant hypotension may limit use of this drug to highly selected patients.
-
Acta Anaesthesiol Scand · May 1987
Randomized Controlled Trial Comparative Study Clinical TrialPrevention of intraoperative hypothermia during abdominal surgery.
Heat balance and core and skin temperatures were studied in 111 patients during abdominal surgery. In minor surgical procedures the effects of heating of inspired humidified gases (n = 23) and of a heating mattress (n = 21) were compared with the conditions in an unwarmed control group (n = 24). ⋯ The combined measures of heated humidified inspired gases, a heating mattress, insulation by a heat-reflecting blanket, warming of all infusions and transfusions and a warm operating room were all needed to balance the great heat losses during the major surgical procedures. With such massive heat supply it was possible to prevent heat loss and a fall in core temperature.
-
Acta Anaesthesiol Scand · May 1987
Comparative StudyA comparison between two emergency cricothyroidotomy instruments.
As part of a training programme for younger doctors, two commercially available, emergency cricothyroidotomy sets were evaluated. Prior to the surgical procedure, half of the doctors in each group received an audiovisual lesson. ⋯ Both systems allowed positive pressure ventilation. The participating doctors achieved a higher success rate at a faster speed with the "Nutrake" set.
-
Acta Anaesthesiol Scand · May 1987
Clinical Trial Controlled Clinical TrialPostoperative pain relief and bupivacaine plasma levels during continuous interscalene brachial plexus block.
Interscalene brachial plexus block was performed on 40 patients for prophylactic pain relief after shoulder surgery. A dose of 1.25 mg/kg of 0.5% bupivacaine was injected for the block (Group 1) and continued with an infusion of 0.25% bupivacaine 0.25 mg/kg/h (Group 2). If the postoperative analgesia was insufficient, the patients received i.m. oxycodone 0.15 mg/kg. ⋯ At 30 min, the mean bupivacaine plasma concentration was 1.0 microgram/ml in Group 1 and 0.9 microgram/ml in Group 2. The mean plasma level of bupivacaine increased from 0.7 microgram/ml after 180 min to 1.1 micrograms/ml (P less than 0.01) after 24 h of infusion, providing some evidence of accumulation during infusion. The dizziness and confusion experienced by three patients could be associated with the local anaesthetic, as they obtained relief after the infusion was stopped.