Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 1997
Case ReportsA survey of the ASA physical status classification: significant variation in allocation among Finnish anaesthesiologists.
The American Society of Anesthesiologists' (ASA) Classification of Physical Health is a widely used grading system for preoperative health of the surgical patient. In previous studies conducted in North America and Great Britain, considerable variation in the ASA classification allocation has been reported. We hypothesised that in smaller and culturally more homogeneous countries there might be less variation in the ASA classification. ⋯ In a small and culturally homogeneous country, like Finland, there exists similar wide variation in the ASA classification as has been previously reported from larger and culturally more heterogeneous countries. The significant variation should always be considered when using this classification in clinical or scientific work.
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Acta Anaesthesiol Scand · May 1997
Randomized Controlled Trial Clinical TrialIntrathecal morphine for post-sternotomy pain in patients with myasthenia gravis: effects on respiratory function.
Thymectomy can induce a remission or at least an improvement in myasthenia gravis (MG) patients. After sternotomy MG patients with compromised muscle strength need an excellent postoperative pain relief. This study was designed to evaluate the efficacy of intrathecal morphine (ITM) on ventilatory function among MG patients undergoing trans-sternal thymectomy, when intravenous morphine served as control. ⋯ Intrathecal morphine provided effective postoperative analgesia and significantly improved ventilatory function when compared with intravenous morphine.
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Acta Anaesthesiol Scand · May 1997
Clinical Trial Controlled Clinical TrialIntravenous phentolamine test--an aid in the evaluation of patients with persistent pain after low-back surgery?
Persistent pain following surgery in the treatment of chronic low-back pain patients is still relatively frequent. Most of these patients with persistent pain have clinical signs of neuropathic pain. The neuropathic pain might be sympathetically maintained pain (SMP) or sympathetically independent pain (SIP). Systemic administration of phentolamine, a competitive alpha-adrenergic antagonist, has been used as a diagnostic tool to identify patients with SMP. ⋯ SMP is either an uncommon cause of persistent pain in this type of failed back surgery patients or the phentolamine test, as we performed it, was unable to identify SMP.
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Acta Anaesthesiol Scand · May 1997
Randomized Controlled Trial Clinical TrialThe effect of acute normovolemic hemodilution on homologous blood requirements and total estimated red blood cell volume lost.
Acute normovolemic hemodilution combined with retransfusion is one of the various techniques proposed to avoid homologous blood transfusion in cardiac surgery. The purpose of the present paper is to study the effect of the volume of autologous blood collected pre-cardiopulmonary bypass (CPB) on homologous blood requirements and total estimated red blood cell (RBC) volume lost in coronary artery bypass grafting (CABG) surgery. ⋯ Acute intraoperative hemodilution with high- and low-volume phlebotomy reduced the homologous blood requirements similarly regardless of the amount of phlebotomy.
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Acta Anaesthesiol Scand · May 1997
Case ReportsLarge increase in cardiac output in a patient with ARDS and acute right heart failure during inhalation of nitric oxide.
Inhaled nitric oxide (NO), a selective pulmonary vasodilator, reduces pulmonary artery pressure in patients with acute respiratory distress syndrome (ARDS). In spite of the reduction of right ventricular afterload, the effect of NO on cardiac output remains unclear. ⋯ Our observations suggest that inhalation of NO is likely to increase cardiac output in ARDS when severe acute right heart failure is present.