Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1997
Case ReportsLong QT interval syndrome with increased QT dispersion.
This case report describes the anaesthetic management of a patient with sporadic-type long QT interval syndrome (LQTS), and increased QT dispersion, who presented for removal of an ovarian cyst. Beta adrenergic blockade and adequate depth of anaesthesia for successful management is emphasized. The successful use of epidural administration of lignocaine and opioids in addition to general anaesthesia is described.
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Acta Anaesthesiol Scand · Apr 1997
Case ReportsSevere complications associated with epidural and spinal anaesthesias in Finland 1987-1993. A study based on patient insurance claims [see comment].
The Patient Injury Act has been in effect in Finland since 1 May 1987. This legislation is a no-fault compensation scheme and implies that if a patient during the course of medical treatment suffers any injury as a result of that treatment he or she may file a claim to the Patient Insurance Association (PIA). From 1 May 1987 to 31 December 1993, 23,500 claims for compensation were made. ⋯ According to this material the incidence of serious complications was 0.45:10,000 following spinal and 0.52:10,000 following epidural anaesthesia. Atraumatic technique, careful patient selection and early diagnosis and treatment of complications are essential in avoiding permanent injury.
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Acta Anaesthesiol Scand · Apr 1997
Peripheral neurologic deficits in relation to subarachnoid or epidural administration of local anesthetics for surgery. A survey of 21 cases.
Recent case reports have suggested that subarachnoid or epidural administration of local anesthetics may cause peripheral neurologic deficits. ⋯ This database study does not contain complete information for the cases reported, and a causal relationship between subarachnoid or epidural administration of local anesthetics and neurologic deficits therefore remains uncertain. The increase in the number of reports on lidocaine after the introduction of very fine-bore spinal needles is consistent with the suspicion that lidocaine at the concentration 50 mg/ml is neurotoxic and that it may not be diluted rapidly enough in the cerebrospinal fluid when injected through such needles.
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Acta Anaesthesiol Scand · Apr 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of continuous epidural infusion of fentanyl and bupivacaine with intermittent epidural administration of morphine for postoperative pain management in children.
The aim of this study was to compare epidural infusion of bupivacaine and fentanyl and intermittent epidural morphine with regard to analgesic effect, and incidence and severity of side effects in children undergoing major abdominal or genito-urological surgery in order to improve the postoperative pain management of children. ⋯ Continuous epidural infusion of fentanyl and bupivacaine was found to be superior to intermittent epidural morphine. The initial regimen should be fentanyl 2 micrograms/ml and bupivacaine 1.0 mg/ml infused at a rate of 0.25 ml.kg-1.h-1.
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Acta Anaesthesiol Scand · Apr 1997
Randomized Controlled Trial Clinical TrialTramadol in the treatment of postanesthetic shivering.
As an inhibitor of the reuptake of serotonin and norepinephrine in the spinal cord, the mechanism of action of tramadol resembles that of nefopam, which has been used in the treatment of postanesthetic shivering. ⋯ Tramadol's distinct features in the treatment of shivering reside in its high safety profile and weak sedative properties, particularly in patients with poor cardiorespiratory reserve, in outpatients and on recurrence of shivering.