Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 1998
Randomized Controlled Trial Clinical TrialEffects of sevoflurane on intracranial pressure, cerebral blood flow and cerebral metabolism. A dose-response study in patients subjected to craniotomy for cerebral tumours.
Studies concerning the cerebrovascular effects of sevoflurane in patients with space-occupying lesions are few. This study was carried out as a dose-response study comparing the effects of increasing sevoflurane concentration (1.5% (0.7 MAC) to 2.5% (1.3 MAC)) on cerebral blood flow (CBF), intracranial pressure (ICP), cerebrovascular resistance (CVR), metabolic rate of oxygen (CMRO2) and CO2-reactivity in patients subjected to craniotomy for supratentorial brain tumours. ⋯ Sevoflurane is a cerebral vasodilator in patients with cerebral tumours. Sevoflurane increases CBF and decreases CVR in a dose-dependent manner. CO2-reactivity is preserved during 1.5% and 2.5% sevoflurane.
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Acta Anaesthesiol Scand · Jul 1998
Randomized Controlled Trial Clinical TrialVomiting, retching, headache and restlessness after halothane-, isoflurane- and enflurane-based anaesthesia. An analysis of pooled data following ear, nose, throat and eye surgery.
Isoflurane has exceeded halothane and enflurane in usage. A literature search, however, revealed no data comparing the effects on emesis, headache and restlessness of these three agents. ⋯ Isoflurane induces less postoperative emesis than halothane, but headache is similarly frequent after anaesthesia with any of these agents.
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Acta Anaesthesiol Scand · Jul 1998
Randomized Controlled Trial Comparative Study Clinical TrialNo inhibition of gastro-intestinal propulsion after propofol- or propofol/ketamine-N2O/O2 anaesthesia. A comparison of gastro-caecal transit after isoflurane anaesthesia.
Gastrointestinal motility may be considerably reduced by anaesthesia and or surgery resulting in postoperative ileus. Inhibition of propulsive gut motility is especially marked after an opioid-based technique. Little, however, is known of the gastrointestinal effects of the hypnotic propofol when given continuously over a longer period of time, which is the case in total intravenous anaesthesia (TIVA) and in intensive care sedation. We therefore set out to study the effects of a propofol-based nitrous oxide/oxygen anaesthesia (group PO) on gastro-caecal transit time. The results were compared with a propofol-ketamine technique (group PK) and an isoflurane-based anaesthesia (group I; each group n = 20). ⋯ The data suggest that propofol, even when given as a continuous infusion, does not alter gastrointestinal tract motility more than a standard isoflurane anaesthesia. The data may be particularly relevant to patients who are likely to develop postoperative ileus. They also suggest that in an ICU setting propofol does not alter gut motility more than a sedation technique with the analgesic ketamine.
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Acta Anaesthesiol Scand · Jul 1998
Incidence of venous and paradoxical air embolism in neurosurgical patients in the sitting position: detection by transesophageal echocardiography.
Venous air embolism (VAE) and paradoxical air embolism (PAE) are serious complications associated with the sitting position for neurosurgery. Although PAE is the result of VAE, the incidence of PAE according to the severity of VAE has not been investigated systematically in humans. ⋯ VAE detected by TEE appeared in all patients undergoing neurosurgery in the sitting position and PAE only occurred following the most severe grade of VAE. To prevent growth of VAE is an important prophylactic for PAE.
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Acta Anaesthesiol Scand · Jul 1998
Comparative StudyEffects of desflurane and propofol on arterial oxygenation during one-lung ventilation in the pig.
Desflurane depresses hypoxic pulmonary vasoconstriction (HPV) in vitro. During one-lung ventilation (OLV), HPV may reduce venous admixture and ameliorate the decrease in arterial O2 tension by diverting blood from the non-ventilated to the ventilated lung. Accordingly, this study compares the effects of desflurane with those of propofol on oxygenation during two-lung (TLV) and OLV in vivo. ⋯ Consistent with in vitro results on HPV, 1 MAC desflurane impaired in vivo oxygenation during OLV more than did propofol.