Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1999
Randomized Controlled Trial Comparative Study Clinical TrialSingle-dose spinal anaesthesia versus incremental dosing for lower limb vascular surgery.
In patients scheduled for vascular surgery, atherosclerotic disease is highly prevalent. Haemodynamic reactions are often aggravated when spinal analgesia is used in this population. No randomized studies have been conducted comparing single shot (SS) with continuous spinal analgesia (CSA) for vascular patients. We did a prospective randomized study comparing haemodynamics when SS versus CSA was performed. ⋯ In this study we found no difference in the haemodynamic response to SS or CSA in patients scheduled for vascular surgery of the legs. SS is easier to apply and is recommended when the duration of surgery allows for it.
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Acta Anaesthesiol Scand · Apr 1999
Randomized Controlled Trial Comparative Study Clinical TrialLumbar versus thoracic epidural buprenorphine for postoperative analgesia following coronary artery bypass graft surgery.
Thoracic epidural analgesia (TEA) is reported to provide effective analgesia following cardiac surgery. We compared the effect of buprenorphine (BN) through the lumbar and thoracic epidural routes for postoperative analgesia following coronary artery bypass graft surgery (CABG). ⋯ This study shows that BN by the lumbar epidural route for analgesia after CABG compares favourably with the same drug through the thoracic route in terms of quality of analgesia and incidence of side effects.
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Acta Anaesthesiol Scand · Apr 1999
Excretion of lidocaine and bupivacaine in breast milk following epidural anesthesia for cesarean delivery.
There is a lack of information and knowledge about the practical importance of even low concentrations of the excretion of local anesthetics into breast milk, particularly concerning bupivacaine. The present work aims to confirm, under practical clinical conditions of admission of parturients, the passage of local anesthetics (lidocaine and bupivacaine) into breast milk after an epidural anesthesia. ⋯ This study documents the magnitude of excreted lidocaine, bupivacaine and PPX in breast milk, and indicates that the use of both lidocaine and bupivacaine for epidural anaesthesia is safe with regard to breast-feeding.
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Acta Anaesthesiol Scand · Apr 1999
Comparative StudyMetabolic regulation of cardiac output during inhalation anaesthesia in dogs.
The metabolic regulation of tissue blood flow manifests itself in a linear relation between blood flow and oxygen consumption, the latter being the independent variable. It is unknown, however, if this fundamental physiological principle operates also during inhalation anaesthesia known to be associated with decreases in both cardiac output (Q) and oxygen consumption (VO2). ⋯ Inhalation anaesthesia is characterized by a uniform Q/VO2 relation with an almost linear course at an anaesthetic concentration up to 2 MAC, regardless of the anaesthetic. Metabolic regulation of blood flow apparently operates also during inhalation anaesthesia up to 2 MAC so that the decrease in VO2 determines Q. This implies that cardiac output alone provides little information on the function of the circulation during inhalation anaesthesia unless related to metabolic demands, i.e. to VO2.
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Acta Anaesthesiol Scand · Apr 1999
Randomized Controlled Trial Comparative Study Clinical TrialFocus on mobilisation after lower abdominal surgery. A double-blind randomised comparison of epidural bupivacaine with morphine vs. lidocaine with morphine for postoperative analgesia.
Epidural infusion of morphine, usually with bupivacaine, for postoperative pain relief has proved to be safe and effective. Lidocaine with its short duration of action and low toxicity may be an alternative to bupivacaine. The clinical importance of the choice of local anaesthetic drug on mobilisation after lower abdominal surgery has not been studied previously. ⋯ There were no clinically or statistically significant differences in the postoperative course after lower abdominal surgery in patients who received an epidural infusion of morphine combined with bupivacaine as compared to patients who received morphine with lidocaine. Further clinical studies to establish the place of lidocaine in postoperative epidural analgesia should be performed.