Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 1995
Hemodynamic changes due to Trendelenburg positioning and pneumoperitoneum during laparoscopic hysterectomy.
More prolonged gynecological laparoscopic operations are being performed in recent years, and a steeper head-down position is required. The early reports of hemodynamic changes during gynecologic laparoscopy are conflicting, and the effects of anesthesia, head-down tilt and pneumoperitoneum have not been clearly separated. Invasive hemodynamic monitoring was carried out in 20 female ASA Class I-II patients who underwent laparoscopic hysterectomy. ⋯ Anesthesia and the Trendelenburg position increased the CVP, PCWP and pulmonary arterial pressures and decreased cardiac output. Pneumoperitoneum increased these pressures further mostly in the beginning of the laparoscopy, and cardiac output decreased towards the end of the laparoscopy. The risk of systemic CO2-embolus was increased during laparoscopy.
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Acta Anaesthesiol Scand · Oct 1995
Case ReportsRepetitive hearing loss following dural puncture treated with autologous epidural blood patch.
A case of repetitive hearing loss following an otherwise uncomplicated diagnostic dural puncture is presented. The patient developed severe postdural puncture headache (PDPH) and three episodes of pronounced vestibulocochlear disturbances within five weeks after only one dural puncture. On all three occasions the headache and the associated symptoms were treated with an autologous epidural blood patch (AEBP) resulting in the immediate disappearance of all the subjective complaints of postdural puncture headache and the normalization of an audiological test within minutes.
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Acta Anaesthesiol Scand · Oct 1995
Neurological complications after anaesthesia. A follow-up of 18,000 spinal and epidural anaesthetics performed over three years.
17 733 consecutive central blocks (8501 spinal and 9232 epidural anaesthetics) performed during a three-year period were analyzed for alleged complications. Neurological complications related to anaesthesia were reported in 17 cases of which 13 patients had persisting lesions after three spinal and ten epidural blocks. ⋯ In five of these cases, polyneuropathy or nonspecific neurological symptoms were present. Three complications after epidural blocks were paraplegias caused by spinal haematomas in patients with deranged haemostatic capacity.