Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 2000
Randomized Controlled Trial Clinical TrialPreoperative treatment with recombinant human erythropoietin or predeposit of autologous blood in women undergoing primary hip replacement.
Controversy exists about the advantages of predeposit of autologous blood (PDAB), and whether more comfortable blood conservation regimens may yield comparable results. To test the hypothesis that preoperative treatment with recombinant human erythropoietin (rHuEPO) with or without acute concomitant normovolaemic haemodilution (ANHD) is as effective as PDAB in reducing allogeneic blood transfusions, we conducted a prospective randomised study in women undergoing primary hip replacement. ⋯ Withdrawal of autologous blood is associated with lower pre- and intraoperative haemoglobin levels when compared to preoperative augmentation of red cell mass using rHu-EPO. As a measure to reduce allogeneic transfusion requirements, preoperative treatment with rHuEPO may be as effective as standard predeposit of autologous blood in women undergoing primary hip replacement, but requires less preoperative time.
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Acta Anaesthesiol Scand · Jul 2000
Randomized Controlled Trial Meta Analysis Comparative Study Clinical TrialPostural post-dural puncture headache. A prospective randomised study and a meta-analysis comparing two different 0.40 mm O.D. (27 g) spinal needles.
To compare the incidence of postural post-dural puncture headache (PPDPH) after spinal anaesthesia using two different 0.40 mm O.D. (27 g) spinal needles: pencil-point needle and Quincke needle. In addition, a meta-analysis of studies comparing small bore spinal needles with regard to development of PPDPH was performed. ⋯ A pencil-point-shaped spinal needle will significantly reduce PPDPH compared with Quincke-type spinal needles, also when small bore needles (0.40 mm O.D.) are used.
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Acta Anaesthesiol Scand · Jul 2000
Clinical TrialPain intensity and side effects during titration of morphine to cancer patients using a fixed schedule dose escalation.
Considerable dose variations and frequent initial side effects have been postulated during start of morphine treatment to patients with pain caused by malignant disease. However, to our knowledge, only one previous study has reported effective doses in morphine naive cancer patients and no prospective evaluation has compared symptoms before with symptoms during morphine titration. ⋯ In cancer patients with uncontrolled pain on weak opioids, successful titration of morphine is achieved fast, with a three-fold morphine dose variation and with little increase in side effects.
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Acta Anaesthesiol Scand · Jul 2000
Randomized Controlled Trial Clinical TrialEpileptiform EEG during sevoflurane mask induction: effect of delaying the onset of hyperventilation.
Hyperventilation during sevoflurane-N2O-O2 mask induction in adults is associated with a hyperdynamic circulatory response and epileptiform electroencephalogram (EEG). We tested the hypothesis that delaying onset of hyperventilation will prevent severe (periodic) epileptiform EEG and hyperdynamic response. ⋯ Regardless of its timing, hyperventilation at a high sevoflurane concentration produced severe epileptiform EEG with a hyperdynamic response. PED tended to occur more often with immediate onset of hyperventilation.
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Acta Anaesthesiol Scand · Jul 2000
Randomized Controlled Trial Clinical TrialTopical tenoxicam from pharyngeal pack reduces postoperative sore throat.
One puff of beclomethasone inhaler has been shown to reduce the incidence of sore throat following endotracheal intubation. The aim of this study was to determine the effect of a pharyngeal pack on the incidence of sore throat and whether tenoxicam-impregnated gauze pack significantly influenced the frequency of sore throat. ⋯ The intraoperative use of a tenoxicam-impregnated gauze pack is effective in reducing moderate or severe postoperative sore throat following the use of throat pack.