Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 1995
Effect of continuous positive airway pressure (CPAP) in patients with chronic obstructive pulmonary disease (COPD) depending on intrinsic PEEP levels.
The application of continuous positive airway pressure (CPAP) is known to reduce inspiratory work of breathing in intubated patients with chronic obstructive pulmonary disease (COPD). This effect is caused by a decrease in elastic work related to a reduction in intrinsic PEEP. The aim of this study was to relate the decrease in inspiratory work due to CPAP to the intrinsic PEEP levels obtained during spontaneous breathing without positive pressure. ⋯ This decrease was found to be related to the intrinsic PEEP-levels; the largest reductions were found in the patients with an intrinsic PEEP-level close to the CPAP-level applied. In intubated patients with COPD, the decrease in Wltot due to a CPAP of 0.5 kPa was found to be related to the intrinsic PEEP-levels present when no positive airway pressure was applied. The intrinsic PEEP measured during tracheal occlusions could be used to estimate the effect of CPAP in these patients.
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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.
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Acta Anaesthesiol Scand · Nov 1995
Hyperkalaemia associated with haemorrhagic shock in rabbits: modification by succinylcholine, vecuronium and blood transfusion.
In haemorrhagic patients, hyperkalaemia may occur after succinylcholine administration. We investigated in haemorrhagic rabbits whether vecuronium caused hyperkalaemia and if blood transfusion prevented succinylcholine-induced hyperkalaemia. Rabbits were lightly anaesthetized with halothane/N2O and 30-35 ml/kg blood were withdrawn to cause arterial pH to decrease to approximately 7.0-7.1. ⋯ The K+ increase at 5 min for Group S (1.8 +/- 0.8) was significantly higher than those for Group C (1.0 +/- 0.6) or Group V (0.9 +/- 0.4), but was not different from that of Group T (1.5 +/- 0.7). We conclude that haemorrhage and succinylcholine cause hyperkalaemia in rabbits. Muscle relaxation itself does not appear to be a factor, but transfusion may lessen the hyperkalaemia.
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Acta Anaesthesiol Scand · Nov 1995
Editorial CommentTime for revivification of paravertebral blocks?