Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 1999
Does desflurane alter left ventricular function when used to control surgical stimulation during aortic surgery?
Although desflurane is commonly used to control surgically induced hypertension, its effects on left ventricular (LV) function have not been investigated in this clinical situation. The purpose of the present study was to evaluate the LV function response to desflurane, when used to control intraoperative hypertension. ⋯ This study demonstrates that in patients at risk for cardiac morbidity undergoing vascular surgery, desflurane is effective to control intraoperative hypertension without fear of major cardiac depressant effect.
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Acta Anaesthesiol Scand · Aug 1999
Randomized Controlled Trial Comparative Study Clinical TrialIntravenous ketoprofen and epidural sufentanil analgesia in children after combined spinal-epidural anaesthesia.
Epidural opioid analgesia has become more popular for postoperative pain treatment in children. Epidural opioids are associated with adverse effects such as respiratory depression, excessive sedation, protracted vomiting, urinary retention and pruritus. Following minor surgery, ketoprofen has a synergistic effect with opioids, resulting in an improved analgesia without increase in incidence of adverse effects. To see whether this is also true following major surgery, we compared the effect of i.v. ketoprofen and placebo as an adjuvant to epidural sufentanil analgesia. ⋯ In this study, ketoprofen as a background analgesic to epidural sufentanil provided improved postoperative analgesia and reduced incidence of adverse effects of the epidural opioid.
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Acta Anaesthesiol Scand · Aug 1999
Randomized Controlled Trial Comparative Study Clinical TrialSingle-injection paravertebral block compared to general anaesthesia in breast surgery.
Breast surgery is frequently associated with post-operative nausea, vomiting, pain and painful restricted movement. Paravertebral block may be an alternative to general anaesthesia for this type of surgery. We studied the single-injection paravertebral block at the level of T4 and report a comparison of single-injection paravertebral block to general anaesthesia for breast surgery. ⋯ Single-injection paravertebral block at the level of T4 represents a suitable alternative to general anaesthesia in women undergoing breast surgery.
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Acta Anaesthesiol Scand · Aug 1999
Randomized Controlled Trial Clinical TrialKetamine antagonises alfentanil-induced hypoventilation in healthy male volunteers.
The effects of ketamine on respiration, alone, or in combination with opioids, have not been completely clarified. Both stimulant and depressant effects have been reported, as well as attenuation of opioid-induced hypoventilation at the expense of increased oxygen consumption. These conflicting results might partly be due to dose-dependent mechanisms. We have, therefore, determined the ventilatory effects of ketamine, in combination with alfentanil, using infusions to different pseudo steady-state concentrations. ⋯ In the dose range of interest for postoperative, intensive-care and pain-clinic settings, ketamine antagonises the resting hypoventilation induced by alfentanil.
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Acta Anaesthesiol Scand · Aug 1999
Comparative StudyFactors affecting gentamicin pharmacokinetics in septic patients.
This prospective, comparative study was designed to estimate the volume of distribution (Vd) and elimination rate constant (K(e)) of gentamicin and to determine the clinical factors affecting the pharmacokinetics of gentamicin in different stages of sepsis. ⋯ The increased Vd in the septic patients was related to the severity of illness and magnitude of cardiac output. The K(e) of gentamicin was correlated with the serum creatinine level.