Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1992
ReviewEffects of anaesthesia and surgery on the immune response.
Alterations have been found to occur in every component of immune response during anaesthesia and surgery. These alterations represent the body's general physiological responses and are mainly dependent on the extent of surgery, as well as other factors such as the patient's age and health status, medication and blood transfusion. Anaesthetic and operative complications have profound effects on these responses. ⋯ Experimental evidence suggests that results of treatment in injured and operated patients can in the future be improved by controlling immune responses and their mediator systems. Our current level of knowledge of immune responses is already helping us to avoid many immune-mediated complications. However, routine interference with these responses is not indicated.
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Acta Anaesthesiol Scand · Apr 1992
Randomized Controlled Trial Clinical TrialThe influence of naloxone infusion on the action of intrathecal diamorphine: low-dose naloxone and neuroendocrine responses.
The influence of an intravenous infusion of naloxone 1 microgram kg-1 h-1, in combination with intrathecal diamorphine, on analgesia and hormonal stress responses after laminectomy was assessed in a blinded, randomized, placebo-controlled study. Twenty-seven patients undergoing laminectomy with postoperative analgesia provided by intrathecal diamorphine were investigated. ⋯ The postoperative concentrations of both blood glucose and serum cortisol were reduced in the naloxone group compared to the control group (P less than 0.05). These results may indicate an excitatory role for the hypothalamic mu receptor in hypothalamo-pituitary-adrenocortical axis regulation.
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Acta Anaesthesiol Scand · Apr 1992
Randomized Controlled Trial Comparative Study Clinical TrialSedation for bronchofiberoscopy: comparison between propofol infusion and intravenous boluses of fentanyl and diazepam.
Two methods of sedation were evaluated in unpremedicated patients undergoing elective bronchofiberoscopy. The patients were randomly allocated to receive either propofol infusion 1 mg kg-1 h-1 preceded by a 1 mg kg-1 bolus (15 patients) (the propofol group) or intravenous fentanyl 1 micrograms kg-1 and diazepam 0.05 mg kg-1 (15 patients) (the fentanyl+diazepam group). Thirteen patients were treated twice during the study period and sedated with both methods (the first treatment according to random order and the second with the method not used on the first occasion). ⋯ The decrease was statistically significant in both groups (P less than 0.001). After sedation, systolic arterial pressures (SAP) decreased in both groups (P less than 0.01). Compared to values immediately before starting bronchofiberoscopy, SAP increased during the procedure in both groups (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · Apr 1992
Case ReportsAn outbreak of Klebsiella oxytoca septicemias associated with the use of invasive blood pressure monitoring equipment.
Seven cases of septicemia with piperacillin-resistant Klebsiella oxytoca (PRKO) occurred at 2-monthly intervals in a thoracic surgery intensive care unit. All PRKO isolates were serotyped, and phenotyped with a biochemical typing system. ⋯ PRKO of the epidemic phenotype was recovered from several non-patient transducer domes. The outbreak ended when transducer heads were disinfected and the use of non-patient domes was abolished.
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Acta Anaesthesiol Scand · Apr 1992
Randomized Controlled Trial Comparative Study Clinical TrialPsychomotor recovery following propofol or isoflurane anaesthesia for day-care surgery.
A newly developed test for the assessment of psychomotor recovery--the perceptive accuracy test (PAT)--is described. Seventy-four subjects who performed the test though that it was easy to perform and some were motivated to try it on a number of occasions. Eight persons performed the test on different days and at different periods of time; the results were consistent and reproducible. ⋯ There was a significant difference (P less than 0.01) in psychomotor recovery on the PAT-200 between the propofol group and control groups, but not in the isoflurane and control groups at 30 min. Both groups had returned to baseline values at 60 min in the PAT-60 and PAT-200. The choice reaction time showed no significant difference in either group 30 min after the anaesthetic.(ABSTRACT TRUNCATED AT 250 WORDS)