Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 1999
Randomized Controlled Trial Clinical TrialTopical wound anaesthesia in children--a temporary postoperative pain relief.
Administration of local anaesthetics into the surgical wound may modulate pain at the peripheral level. A previous study in adults has shown good analgesic effects of topical lidocaine in wounds after herniorrhaphy. ⋯ A very short and clinically insignificant pain relief is obtained following the administration of a lidocaine aerosol in the surgical wound. A low pain level in this model may limit the possibility to detect an effect of lidocaine.
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Acta Anaesthesiol Scand · Feb 1999
Randomized Controlled Trial Clinical TrialLack of pre-emptive analgesic effect of (R)-ketamine in laparoscopic cholecystectomy.
This study evaluated the pre-emptive analgesic effect of intravenous (i.v.) (R)-ketamine in laparoscopic cholecystectomy. (R)-ketamine was used due to the lower incidence of side-effects. ⋯ In this study a 1 mg/kg dose of (R)-ketamine given at the end of surgery exerted a short-lasting hypnotic and analgesic effect. The same dose given preoperatively did not show postoperative analgesic effect or pre-emptive effect.
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Acta Anaesthesiol Scand · Feb 1999
Clinical TrialIn-hospital cardiopulmonary resuscitation. 5 years' incidence and survival according to the Utstein template.
Direct comparison of survival rates from in-hospital cardiopulmonary resuscitation (CPR) remains difficult. The objective of this study was to report outcome according to the Utstein template for in-hospital cardiac arrest and to evaluate the Utstein template itself as applied to a retrospective material. ⋯ More than 90% of in-hospital deaths in this hospital are handled without CPR being initiated. Overall survival was 17%, and almost all survivors made a favourable outcome. The Utstein template for in-hospital cardiac arrest performed acceptably as a framework for reporting outcome in this retrospective study.
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Acta Anaesthesiol Scand · Feb 1999
Clinical TrialPerioperative ST-segment depression and troponin T release. Identification of patients with highest risk for myocardial damage.
Patients undergoing major vascular surgery are at constant risk of developing perioperative myocardial complications, especially myocardial infarction. The following study was performed to answer the question whether ST segment changes, analysed by Holter monitoring and ST segment analysis, are accompanied by release of cardiac troponin T, a highly specific marker of myocardial damage. ⋯ Haemodynamic changes, oxygen imbalance and stress during major vascular surgery frequently lead to an ischaemic burden, which is indicated by ST segment changes during ECG ST analysis. Longlasting ST depression reaching an individual critical cut-off limit followed by structural myocardial damage may be verified by elevated levels of cardiac troponin T. Prolonged periods of ST depression should be followed by determination of cardiac troponin T.
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Acta Anaesthesiol Scand · Feb 1999
Attitudes of Swedish physicians and nurses towards the use of life-sustaining treatment.
Withdrawal or withholding of life-sustaining treatment have become accepted clinical practice within the intensive care unit (ICU). One important factor influencing these decisions is the attitudes of physicians and nurses. ⋯ Advance directives are believed by Swedish intensive care personnel to be very important in the decision to withdraw life support, contrary to several descriptive studies suggesting modest patient and family influence on these decisions. Attitudes towards the intensity of care vary between different centers, raising the possibility that levels of care for similar patients may differ across the country.