Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2000
Case ReportsTwo instances of central nervous system toxicity in the same patient following repeated ropivacaine-induced brachial plexus block.
We describe two instances of central nervous system (CNS) toxicity in the same patient following repeated brachial plexus blocks induced by high doses of ropivacaine (6 mg x kg(-1) and 4.5 mg x kg(-1), respectively). Although very high total and free plasma concentrations of ropivacaine were found up to 98 min after induction of the blocks, no signs of cardiovascular toxicity apart from hypertension and sinus tachycardia were observed. ⋯ These high doses, however, resulted in severe toxic CNS symptoms. Therefore, it is stressed that the dose in relation to the weight of the patient must be calculated when administering a large volume of local anesthetic.
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Inhalational induction is one of the recognized methods for the management of difficult airway. Halothane is the usual choice of agent for this purpose. ⋯ There are various reports for and against the use of sevoflurane for the management of difficult airway. We describe the use of sevoflurane for the management of difficult airway in four patients presenting with airway problems.
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Acta Anaesthesiol Scand · May 2000
Randomized Controlled Trial Comparative Study Clinical TrialNo difference between bupivacaine in 0.9% and 8% glucose for spinal anaesthesia in small children.
Baricity is one of the most important factors to influence the characteristics of distribution of the local anaesthetic and hence success and spread of the blockade. Bupivacaine is rendered hyperbaric by adding glucose. The effect of differing degrees of hyperbaricity remains to be evaluated. ⋯ These results demonstrate that bupivacaine in 0.9% glucose and in 8% glucose solutions are equally suitable for spinal anaesthesia in small children. Similar success rate, spread and duration of the sensory and motor block are achieved with both baricities of bupivacaine.
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Acta Anaesthesiol Scand · May 2000
Randomized Controlled Trial Comparative Study Clinical TrialRegional anaesthesia for outpatient knee arthroscopy: a randomized clinical comparison of two different anaesthetic techniques.
The purpose of this prospective, randomized study was to evaluate the time required to perform anaesthesia, achieve surgical block and fulfil standardized discharge criteria in outpatients receiving knee arthroscopy with either spinal anaesthesia or combined sciatic-femoral nerve block. ⋯ In patients receiving elective outpatient knee arthroscopy, using a combined sciatic-femoral nerve block with 25 ml of mepivacaine 20 mg ml(-1) and a multiple injection technique results in a slightly longer preoperative time but provides similarly effective anaesthesia with no differences in home discharge times as compared to spinal anaesthesia with 8 mg hyperbaric bupivacaine.
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Acta Anaesthesiol Scand · May 2000
Randomized Controlled Trial Clinical TrialLocal anaesthesia for awake fibreoptic nasotracheal intubation.
Awake fibreoptic nasotracheal intubation (FNI) is performed in potentially difficult airways under local anaesthesia. This observer-blinded study was designed to evaluate the efficacy of upper airway anaesthesia produced by nebulized lignocaine against combined regional block (CRB) for awake FNI. ⋯ Both nebulization and CRB produced satisfactory anaesthesia of the upper airway, but CRB provided better patient comfort and haemodynamic stability.