Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 1998
Randomized Controlled Trial Clinical TrialHypertonic saline and dextran after coronary artery surgery mobilises fluid excess and improves cardiorespiratory functions.
Extracorporeal circulation induces increased capillary permeability with fluid leakage into the interstitial space, resulting in positive fluid balance and intravascular hypovolaemia. Hypertonic saline 75 mg.ml-1 in dextran 70, 60 mg.ml-1 (HSD) seems to be of benefit in patients with impaired perfusion. The purpose of the study was to investigate the effects of HSD infusion on fluid balance and cardiorespiratory functions just after the end of cardiac surgery. ⋯ The present study documents that infused hypertonic saline with dextran just after the end of cardiac surgery resulted in mobilisation of the intraoperative fluid excess with increased urine output in the early postoperative period and improved gas exchange. Despite reduced need for extra i.v. fluid and decreased cumulative fluid balance, after HSD infusion the patients had increased filling pressures of the heart with improved cardiac output.
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Acta Anaesthesiol Scand · Feb 1998
Intubation difficulties in patients with rheumatoid arthritis. A retrospective analysis.
Fibreoptic intubation has been suggested to be the best method to manage a compromised airway. This retrospective study was designed to compare endotracheal intubation with the help of a rigid laryngoscope or a fibrescope in patients with rheumatoid arthritis. ⋯ The introduction of fibreoptic intubation technique has had a favourable influence on the safety in the airway management of surgical patients with rheumatoid arthritis.
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Acta Anaesthesiol Scand · Feb 1998
Randomized Controlled Trial Clinical TrialEfficacy of EMLA cream prior to dorsal penile nerve block for circumcision in children.
While circumcision may be performed solely with dorsal penile nerve block (DPNB), some painful steps in its use are skin needle penetration and infiltration of the anesthetic product. The objective of this study was to evaluate the efficacy of EMLA cream, prior to DPNB for circumcision in children. ⋯ Since the dorsal penile nerves are located under the Buck's fascia, topical anesthesia may not reach them and other techniques may be necessary to anesthetize them. We found that although EMLA cream is efficient as a topical anesthesia during needle penetration for DPNB, it has no beneficial effect during infiltration.
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Acta Anaesthesiol Scand · Feb 1998
Randomized Controlled Trial Comparative Study Clinical TrialEffects of propofol vs isoflurane on respiratory gas exchange during laparoscopic cholecystectomy.
Respiratory function and pulmonary gas exchange are affected in laparoscopic procedures where a pneumoperitoneum is introduced using CO2. Previous studies have shown differing results concerning pulmonary gas exchange during laparoscopic procedures: Whereas in patients undergoing isoflurane anaesthesia decreases in PaO2 are demonstrated, this factor remains unchanged in patients undergoing propofol anaesthesia. In the present study, the effects of propofol on pulmonary gas exchange were compared with those of isoflurane in patients undergoing elective laparoscopic cholecystectomy in a prospective randomised manner. ⋯ This study demonstrates that pulmonary gas exchange in patients with laparoscopic cholecystectomy is affected by the choice of anaesthetic procedure. During and after laparoscopic cholecystectomy using isoflurane as the anaesthetic, the PaCO2 is significantly higher and the PaO2 significantly lower than they are with propofol.
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Acta Anaesthesiol Scand · Feb 1998
Randomized Controlled Trial Comparative Study Clinical TrialComparison of subhypnotic doses of thiopentone vs propofol on the incidence of postoperative nausea and vomiting following middle ear surgery.
Middle ear surgery is associated with a high incidence of emetic sequelae and propofol has been reported to have antiemetic activity in subhypnotic doses. ⋯ Propofol at a subhypnotic dose of 0.5 mg.kg-1 provides prophylaxis against retching and vomiting for the first 6 h postoperatively after middle ear surgery. The incidence of nausea was not reduced by propofol.