Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Jan 1988
Case ReportsAccidental puncture of the right lymphatic duct during pulmonary artery catheterization. A case report.
A case of an accidental placement of the introducer sheath of a Swan Ganz catheter into the right lymphatic duct during right internal jugular vein catheterization is presented. This rare complication has to be reported, because the choice of the right internal jugular vein for central venous catheterization has been strongly recommended, with special concern being paid to the avoidance of any thoracic duct injury. No deleterious complications were observed either in the immediate or in the later postanaesthetic period.
-
Acta Anaesthesiol Scand · Jan 1988
Measurement of acceleration: a new method of monitoring neuromuscular function.
A new method for monitoring neuromuscular function based on measurement of acceleration is presented. The rationale behind the method is Newton's second law, stating that the acceleration is directly proportional to the force. For measurement of acceleration, a piezo-electric ceramic wafer was used. ⋯ In five patients not given any relaxant during the anaesthetic procedure (20-60 min), both responses were remarkably constant. In 30 patients given vecuronium, a close linear relationship was found during recovery between ACT-TOF and FDT-TOF ratios. It is concluded that the method fulfils the basic requirements for a simple and reliable clinical monitoring tool.
-
Acta Anaesthesiol Scand · Jan 1988
Randomized Controlled Trial Comparative Study Clinical TrialEpidural versus combined spinal epidural block for cesarean section.
In a controlled study a single segment combined spinal epidural (CSE) block was compared with epidural block for cesarean section. Thirty healthy parturients were randomly divided into two groups. In both groups a T4 block was aimed at. ⋯ Apgar scores, blood gases and neurobehavioural evaluation did not show any differences between the two groups of neonates. No postspinal headache was noted. CSE block appears to combine the reliability of spinal block and the flexibility of epidural block while minimizing their drawbacks.
-
A new neuromuscular transmission monitor based on measurement of acceleration is presented. The monitor consists of an acceleration transducer, i.e. a piezo-electric ceramic wafer with an electrode on each side, and a stimulation and computing unit. The transducer can be fastened to the thumb, and when the finger is moved in response to nerve stimulation a voltage difference develops between the two electrodes. ⋯ The acceleration transducer does not require preload, but merely that the muscle on which the measurement is being made can move freely. The accelograph is therefore easy to set up and operate. In daily clinical practice it has proved possible, using this new apparatus, to achieve reliable evaluation of the degree of non-depolarizing neuromuscular blockade in less than 2 min.
-
Acta Anaesthesiol Scand · Jan 1988
Pulmonary complications after upper abdominal surgery: their prevention with intercostal blocks.
A prospective study of postoperative pulmonary complications (PPC) appearing during the hospital stay was carried out in 417 patients undergoing surgery through a subcostal or midline incision. Postoperative pain was relieved either by intercostal block and centrally-acting analgesics on demand or by centrally-acting analgesics alone. Pulmonary complications were diagnosed from combined physical and radiological signs. ⋯ Indeed, an increased rate of PPC was found in our patients over the age of 60 who had received bilateral intercostal blocks. Irrespective of the type of incision, surgery or method of postoperative pain relief, the patients with PPC more often had respiratory or other disorders preoperatively or a surgical complication intra- or postoperatively than those with normal postoperative recovery. Predisposing physical factors and high age were more common among the patients developing PPC in spite of treatment with intercostal blocks compared to those without such treatment.