Acta anaesthesiologica Scandinavica
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Thoracic paravertebral nerve blockade, although once widely practised, has now only a few centres which contribute to the literature. Data production has, however, continued and this review correlates this new information with existing knowledge. Its history, taxonomy, anatomy, indications, techniques, mechanisms of analgesia, efficacy, contraindications, toxicity, side effects and complications are reviewed. ⋯ For unilateral surgery of the chest or truck, thoracic paravertebral analgesia should be considered as the afferent block of choice. For bilateral surgery, its efficacy may be limited by the doses of local anaesthetic which could safely be used and further study in this area in particular is required. This form of afferent blockade deserves greater consideration and investigation.
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Acta Anaesthesiol Scand · Nov 1995
Randomized Controlled Trial Clinical TrialDoes a local anaesthetic cream (EMLA) alleviate pain from heel-lancing in neonates?
EMLA cream is an effective local anaesthetic agent for venipunctures in adults and children. The aim of this double-blind, randomised, and placebo-controlled study was to evaluate the effect of EMLA when heel-lancing was performed in neonates. On their third day of life, fullterm healthy infants, who underwent testing for phenylketonuria (PKU) by heel-lancing, were consecutively included in the study. ⋯ The response to the nociceptive stimulation was assessed by studying the occurrence of a pain cry. No analgesic effect of EMLA was found. There were no adverse effects.
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Acta Anaesthesiol Scand · Nov 1995
Randomized Controlled Trial Clinical TrialEffects of ephedrine on oxygen consumption and cardiac output.
Bolus doses of ephedrine are often used by anaesthesiologists for intraoperative hypotension. This randomized single-blind cross-over study was designed to simultaneously evaluate circulatory, respiratory and metabolic effects of intravenously given ephedrine in 12 healthy male volunteers. Oxygen uptake and carbon dioxide excretion were measured with indirect calorimetry and non-invasive transthoracic electrical bioimpedance was used for cardiac output measurements. ⋯ There were no significant changes in the quotient between oxygen uptake rate and cardiac index, VO2/CI during the 30 min study period. The O2 saturation was not altered. The present study indicates that ephedrine increases oxygen demand and supply in a similar magnitude.
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Acta Anaesthesiol Scand · Nov 1995
Randomized Controlled Trial Comparative Study Clinical TrialComparison of propofol and increased doses of thiopentone for laryngeal mask insertion.
Conditions for insertion of the laryngeal mask were assessed following induction of anaesthesia with either propofol 2.5 mg/kg, thiopentone 5.0 mg/kg or thiopentone 6.0 mg/kg in 120 patients premedicated with diazepam 10 mg. Insertion following induction with thiopentone 5.0 mg/kg and 6.0 mg/kg resulted in a greater incidence of gagging (P < 0.001 and P < 0.05, respectively) compared with propofol 2.5 mg/kg.
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Acta Anaesthesiol Scand · Nov 1995
Randomized Controlled Trial Clinical TrialIntra-arterial regional anaesthesia for hand surgery with alkalinized 0.5% lignocaine.
Intra-arterial regional anaesthesia (IARA) for hand surgery is an old, forgotten technique. One of the causes of low popularity may be a scalding sensation in the hand during intra-arterial injection of lignocaine, which may be caused by low pH of lignocaine's solution. In this randomized, double-blind study, normal (pH 5.2-5.3) or alkalinized (pH 7.2-7.3) preservative-free 0.5% lignocaine 1.5 mg kg-1 was injected into the radial arteries of forty adult patients to produce anaesthesia for ambulatory hand surgery. ⋯ Nine patients in group 1 and seven in group 2 developed minor bruises after cannulation (NS). No other sequelae of intra-arterial injections were observed. We conclude that alkalinized 0.5% lignocaine was less painful on injection than normal lignocaine and should be preferred for intra-arterial anaesthesia for hand surgery.