Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 1995
Randomized Controlled Trial Comparative Study Clinical TrialIs the pencil point spinal needle a better choice in younger patients? A comparison of 24G Sprotte with 27G Quincke needles in an unselected group of general surgical patients below 46 years of age.
Reports have indicated that there are less postoperative complaints after the use of pencil pointed spinal needles. We compared a 24G Sprotte needle with a 27G Quincke needle in a randomised study of 200 healthy patients (49% females), aged 15-46 years. Four patients (2%) reported postdural puncture headache, three with the 24G Sprotte needle and one with the 27G Quincke needle. ⋯ Of the 57 (29%) who reported backpain, a significantly higher proportion had received spinal anaesthesia with the Sprotte needle (OR = 2.06). There was a significantly higher incidence of insufficient blocks after dural puncture with the Sprotte needle. Ease of needle insertion and number of puncture attempts was the same for both needle types.
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Acta Anaesthesiol Scand · May 1995
Randomized Controlled Trial Clinical TrialHigh dose spinal anaesthesia with glucose free 0.5% bupivacaine 25 and 30 mg.
The purpose of this study was to investigate if a more intense and/or prolonged blockade could be obtained safely when a high-dose intrathecal plain bupivacaine was given. Thirty patients for elective surgery were included. Two groups of 15 patients, received 25 or 30 mg 0.5% bupivacaine (plain). ⋯ The total duration of analgesia did not differ significantly between the groups. A significantly longer duration of maximal cephalad spread, and a slower initial regression, was found in the 30 mg group. No severe uncontrolled haemodynamic or respiratory side effects occurred.
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Acta Anaesthesiol Scand · May 1995
Randomized Controlled Trial Comparative Study Clinical TrialAnaesthesia for short outpatient procedures. A comparison between thiopentone and propofol in combination with fentanyl or alfentanil.
We studied supplementation of propofol or thiopentone anaesthesia with 0.5 or 1.0 mg alfentanil or 0.05 or 0.1 mg fentanyl for minor gynaecological outpatient procedures. Four hundred patients scheduled for elective termination of pregnancy were randomly allocated to one of eight groups. Induction agent doses, peroperative complications, complaints about pain and emesis during the postoperative period, and time to discharge were studied. ⋯ The need for postoperative reserve analgesics was less in the alfentanil group (P < 0.05). We found, however, no major differences between the supplementations tested regarding the total dose of induction agent, emesis or time to discharge. Supplementation with 1.0 mg of alfentanil to propofol was found to be the best combination tested for short outpatient procedures.
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Acta Anaesthesiol Scand · May 1995
Case ReportsSpinal subdural bleeding after attempted epidural and subsequent spinal anaesthesia in a patient on thromboprophylaxis with low molecular weight heparin.
Despite the extensive use of low molecular weight heparins (LMWH) for thromboprophylaxis, only two serious complications have thus far been reported where spinal haematomas were incurred after epidural and spinal blocks in patients on such treatment. In our patient, who was on thromboprophylaxis with the LMWH drug enoxaparin, catheter epidural anaesthesia was abandoned due to a bloody tap and superseded by spinal anaesthesia. More than 40 hours later she had developed a paraparesis and complete sensory loss in the lower extremities. The MRT image showed haematomas epi- and subdurally, as well as subarachnoidally, but no epidural bleeding was seen at laminectomy.
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Acta Anaesthesiol Scand · May 1995
Comparative StudyContinuous cardiac output measurements in the perioperative period.
Management of critically ill patients is based on knowledge of fundamental physiologic variables. Automatized and continuous measurement of these variables is preferable. A new system based upon the thermodilution method has been developed to measure cardiac output automatically and continuously. ⋯ In conclusion, the CCO measurement technique is a promising clinical method. The method is straightforward, requires no calibration, is independent of vascular geometry and measures with its limitations volumetric flow. Finally automatic and continuous patient monitoring provides more information and has potential to reveal previously undetected haemodynamic events.