Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2000
Comparative Study Clinical Trial Controlled Clinical TrialA comparison of three doses of sufentanil in combination with bupivacaine-adrenaline in continuous epidural analgesia during labour.
Sufentanil is now frequently added to local anaesthetic in labour epidural analgesia. However, this opioid has some side effects such as pruritus, and in higher doses could harm the neonate. The purpose of this study was to compare three doses of sufentanil combined with low-dose bupivacaine, to determine the lowest appropriate dose. ⋯ We found no difference in the analgesic effect between three different concentrations of sufentanil. We conclude that the lowest dose may be used. This should decrease the risk of adverse effects on mother and child.
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Acta Anaesthesiol Scand · Sep 2000
Clinical TrialCutaneous sympathetic vasoconstrictor reflexes for the evaluation of interscalene brachial plexus block.
Although signs of sympathetic blockade following interscalene brachial plexus block include Horner's syndrome, increased skin temperature and vasodilatation, the degree of sympathetic blockade is not easily determined. The aim of this study was, therefore, to use activation of cutaneous finger pad vasoconstrictor reflexes for description and quantification of the degree of sympathetic blockade following unilateral interscalene brachial plexus block. ⋯ Interscalene brachial plexus block reduces regional sympathetic nervous activity, illustrated by increases in skin blood flow, skin temperature and attenuated vasoconstrictor responses to an inspiratory gasp. The inspiratory gasp vasoconstrictive response is a powerful and sensitive indicator for monitoring the sympathetic blockade following interscalene brachial plexus block.
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Acta Anaesthesiol Scand · Sep 2000
Clinical TrialThe N-methyl-D-aspartate-receptor antagonist dextromethorphan lacks analgesic effect in a human experimental ischemic pain model.
N-methyl-D-aspartate-receptor antagonists may be useful in pain management. The aim of this study was to evaluate dextromethorphan (DEX), a commonly used oral antitussive drug with NMDA-receptor antagonistic properties, in respect of its analgesic properties as single drug and co-administered with morphine (MO) on experimental ischemic pain. In addition, the analgesic effects of another clinically available NMDA-receptor antagonist, ketamine (KET) as well as of morphine (MO) were tested as active controls. ⋯ DEX in clinical doses has no effect on the present acute ischemic pain model and does not influence MO-induced analgesia. Further studies on other pain modalities are needed in order to evaluate the potential use of DEX in pain treatment.
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Acta Anaesthesiol Scand · Sep 2000
Clinical TrialElastic pressure-volume curves indicate derecruitment after a single deep expiration in anaesthetised and muscle-relaxed healthy man.
In acute respiratory distress syndrome, lung volume is lost immediately after positive end-expiratory pressure (PEEP) is removed and is not immediately regained when PEEP is restored to its original value. The aim of this study was to investigate whether the same phenomenon also occurs in cardiopulmonary healthy individuals during anaesthesia and muscle relaxation. ⋯ During anaesthesia and muscle paralysis, the Pel-V relations change immediately when 5 cmH2O of PEEP is removed. This phenomenon is probably mainly caused by closure of small airways and only in a minor part, if any, by formation of atelectasis. This study indicates that under these conditions lung volume might easily be normalised by a large breath producing an airway pressure of 20 cmH2O.
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Acta Anaesthesiol Scand · Sep 2000
The effect of the obstetrician group and epidural analgesia on the risk for cesarean delivery in nulliparous women.
The effects of regional anesthesia and of the obstetrician on the risk of cesarean delivery remain controversial. The purpose of this study was to determine whether epidural analgesia or the obstetrician group is associated with an increase in the risk for cesarean delivery in nulliparous women. ⋯ The obstetrician group is independently associated with the risk of cesarean delivery in nulliparous women, but we could not demonstrate this association with epidural analgesia. We suggest that in future studies regarding epidural analgesia and cesarean delivery, the obstetrician group should be included as a variable.