Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2000
Midlatency median nerve evoked responses during recovery from propofol/sufentanil total intravenous anaesthesia.
Median nerve somatosensory evoked responses (MnSSER) are frequently used to monitor the integrity of the somatosensory pathway during surgery. We investigated MnSSER components during the wakeup phase from anaesthesia with propofol/sufentanil, because detailed information is lacking about the reversibility of anaesthetic induced changes of MnSSER. The aim of the study was to document precisely the MnSSER waves in relation to the clinical awakening. The hypothesis was that anaesthetic induced MnSSER changes are reversed when the patient becomes responsive after anaesthesia. ⋯ Persistent changes of MnSSER waves > or =35 ms reflect impaired signal processing along the somatosensory pathway following propofol/sufentanil anaesthesia when the patients are responsive again. Further studies combining MnSSER recording with distinct neuro-psychological tests are needed to define the clinical relevance of these findings.
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Acta Anaesthesiol Scand · Mar 2000
Estimation of cardiac preload changes by systolic pressure variation in pigs undergoing pneumoperitoneum.
Variations in systolic pressure arterial waveform (SPV) and its component have been shown to be a reasonable indicator of left ventricular preload. Creation of a pneumoperitoneum (PMOP) by insufflation of CO2 increases intrathoracic pressure, leading to overestimation of preload as assessed by pressure methods. The purpose of this study was to compare SPV with other standard methods in anaesthetized pigs. ⋯ In anaesthetized pigs, the creation of a PMOP alters SPV, likely by decreasing lung compliance. Once PMOP is established, changes in cardiac preload could be estimated by SPV analysis.
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Acta Anaesthesiol Scand · Mar 2000
Postoperative pain control by epidural analgesia after transabdominal surgery. Efficacy and problems encountered in daily routine.
The efficacy of postoperative epidural pain treatment has been well documented in controlled studies. However, the literature concerning results of daily routine use of this method often only emphasises certain aspects of it. ⋯ Analgesia was insufficient when coughing and moving in an unacceptably large number of the patients. Also the number of epidural catheter related problems was high. In order to make early intervention possible, the patients and epidural catheters should be observed daily and systematically by members of the staff competent to detect possible problems.
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Acta Anaesthesiol Scand · Mar 2000
Randomized Controlled Trial Comparative Study Clinical TrialThe incidence of transient neurologic symptoms (TNS) after spinal anaesthesia in patients undergoing surgery in the supine position. Hyperbaric lidocaine 5% versus hyperbaric bupivacaine 0.5%.
The incidence of TNS after spinal anaesthesia is a problem. Especially the use of hyperbaric lidocaine in patients placed in the lithotomy position during surgery has been associated with a high incidence of TNS. The present study was performed to investigate whether TNS is present more frequently in patients undergoing surgery in the supine position with use of hyperbaric lidocaine compared with hyperbaric bupivacaine. ⋯ TNS is a significant problem in patients having spinal anaesthesia with hyperbaric lidocaine compared to hyperbaric bupivacaine, both in the supine position. For day-case surgery, TNS would start after dismissal from hospital. The use of hyperbaric lidocaine is therefore questionable, even though these problems are of an order that the majority of patients would still choose spinal anaesthesia for future operations.