Acta anaesthesiologica Scandinavica
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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
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thromboprophylaxis with the LMWH drug enoxaparin, catheter epidural anaesthesia was abandoned due to a bloody tap and superseded by spinal anaesthesia.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
Randomized Controlled Trial Comparative Study Clinical TrialSevoflurane for ENT-surgery in children. A comparison with halothane.
Sevoflurane, a new volatile anesthetic agent, is of great potential interest in pediatric anesthesia. Its use for ENT surgery in children was compared with halothane in this study. Altogether 40 children participated in the investigation. ⋯ Initially, postoperative excitement occurred more often after sevoflurane, when paracetamol was given during anesthesia, which was reduced (P < 0.01) when paracetamol was given at the time for premedication. It is concluded that sevoflurane is an excellent induction agent, and maintains heart rate and systolic blood pressure better than when halothane is used. The incidence of cardiac arrhythmia is lower with sevoflurane than with halothane.(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · May 1995
Randomized Controlled Trial Comparative Study Clinical TrialResponse to single twitch or single burst stimulation of the ulnar nerve as predictive guide for intubating conditions.
Disappearance of response to single twitch stimulation (STS) or train-of-four stimulation (TOF) of the ulnar nerve is insufficient as predictive guide for intubating conditions during onset of non-depolarizing neuromuscular block. Double burst stimulation (DBS) appears to be a more reliable indicator of the optimal time for intubation. In the present study, the disappearance of tactile detectable response to 0.1 Hz single twitch stimulation (STS) of the ulnar nerve was compared with disappearance of response to 0.1 Hz single burst stimulation (three stimuli at 50 Hz = SBS) as predictor for optimal intubating conditions during onset of block induced by 0.08 mg.kg-1 of vecuronium in 100 patients under light general anaesthesia where thiopentone was used as the sole anaesthetic. ⋯ Intubating conditions were unacceptable in 10%, 14%, 8% and 10% of the patients in the 0.1 Hz STS, 0.1 Hz SBS, 0.05 Hz STS and 0.05 Hz SBS groups, respectively. There were no significant differences between the groups. In conclusion, neither absence of response to STS stimulation nor absence of response to SBS stimulation of the ulnar nerve at either 0.1 Hz or 0.05 Hz frequency does guarantee acceptable intubating conditions during onset of neuromuscular block induced by vecuronium 0.08 mg.kg-1 when thiopentone is used as the sole anaesthetic.
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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.