Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1990
A prospective study of mortality associated with anaesthesia and surgery: risk indicators of mortality in hospital.
The aims of this study were to: 1) determine the incidences and causes of mortality associated with anaesthesia and surgery, 2) identify important factors associated with mortality in hospital, and 3) estimate the mortality risk associated with anaesthesia and surgery when a combination of risk factors are present. A total of 7306 anaesthetized patients undergoing abdominal, urological, gynaecological, or orthopaedic surgery were included in the study. Of these, 0.05% (1:1800) died during anaesthesia, 0.1% (1:730) during the recovery period, and the overall mortality rate in hospital was 1.2% (1:81). ⋯ By utilizing logistic regression analysis, a model for prediction of mortality risk was developed. The model included five significant preoperative predictive variables: age; patients with history of chronic heart disease, and renal disease; emergency surgery; and the type of operation. With this model it is possible to distinguish between patients with very different mortality risks.
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Acta Anaesthesiol Scand · Apr 1990
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative emesis after pediatric strabismus surgery: the effect of dixyrazine compared to droperidol.
Sixty-one children, ASA physical status I, aged 2-14 years, admitted for strabismus surgery were studied. All were premedicated with diazepam and atropin rectally. Anesthesia was induced with thiopental or with halothane on a facemask, and succinylcholine was given to facilitate tracheal intubation. ⋯ The incidence of vomiting during the following 24 h was 65% in the control group, 48% in the droperidol group, and 25% in the dixyrazine group (P less than 0.05 as compared to the control group). Four hours after the operation, six children in the droperidol group and none in the dixyrazine group (P less than 0.05) were difficult to arouse. It is concluded that dixyrazine reduces the incidence of postoperative vomiting without causing heavy sedation.
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Acta Anaesthesiol Scand · Apr 1990
Randomized Controlled Trial Clinical TrialPredictable PaCO2 with two different flow settings using the Mapleson D system.
Two different settings of fresh gas flow (VFG) and minute ventilation (VE) used with the coaxial Mapleson D system (Bain), were evaluated in 59 adults (ASA I-III) during controlled ventilation and different types of surgical procedures. The two flow settings (alternatives A and B) were VFG of 75 and 110 ml.min-1.kg-1 and VE of 150 and 175 ml.min-1.kg-1, aiming to generate normocapnea and mild hypocapnea, respectively. ⋯ With alternative B, the PaCO2 was 4.4 +/- 0.5 kPa, with 82% of the patients within the range 3.5-4.9 kPa. It is concluded that these two flow regimes are suitable for clinical use when either normocapnea or mild hypocapnea is desired.
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Acta Anaesthesiol Scand · Apr 1990
Comparative StudyComparison of anaesthesia ventilators using a lung model.
The ventilatory performance of six anaesthesia ventilators (Alphavent Drägerwerk; MCM 801 Ventilator Dameca; Ohmeda 7000 Ventilator and Ohmeda 7800 Ventilator Ohmeda; Servo Ventilator 900 D and Ventilator 710 Siemens-Elema) was tested in a lung model and compared with the ventilatory performance of the old Engström 300 (Gambro Engström). The lung model consisted of one tracheal tube, two bronchial tubes which could be partially occluded, and two lungs (glass jars filled with water to a suitable compliance). ⋯ All ventilators had a linear relationship between dialled and measured volume. Only the Servo Ventilator 900 D produced a gas distribution which was as good as, or better than that produced by the Engström 300.
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Acta Anaesthesiol Scand · Apr 1990
Randomized Controlled Trial Clinical Trial Controlled Clinical TrialThe experience of the person ventilating the lungs does influence postoperative nausea and vomiting.
One hundred and ninety-eight patients undergoing elective abdominal hysterectomy were anaesthetized with isoflurane in nitrous oxide and oxygen. Ventilation before endotracheal intubation was carried out either by an experienced senior or by an inexperienced junior member of the anaesthetic team. ⋯ Patients whose lungs had been ventilated by experienced members of staff had significantly less (P less than 0.05 to 0.01) postoperative emesis in the recovery room (incidence of emesis 35%) and 2-6 h after operation (incidence 27%) when compared to patients whose lungs had been ventilated by inexperienced members of staff (incidence of emesis 54% and 40% in the recovery room and after 2 to 6 h, respectively). The results suggest that the experience of the person ventilating the lungs is associated with postoperative nausea and vomiting.