Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Oct 2001
Losartan increases renal blood flow during isoflurane anesthesia in sheep.
Inhaled anesthetics cause a transient reversible depression of renal function by direct renal effects or indirectly by changes in neurohumoral systems or cardiovascular performance. When the sympathetic nervous activity is decreased during anesthesia, other vasoactive systems like vasopressin (AVP) and particularly the renin angiotensin system (RAS) are of importance for blood pressure maintenance. Little is known about how the renal circulation is affected by angiotensin receptor blockade during isoflurane anesthesia. ⋯ We conclude that the sympathoadrenal system is still the major determinant for blood pressure maintenance during isoflurane anesthesia in sheep. The apparently increased activity of the renin angiotensin system in this situation causes a reduction in renal blood flow, which is counteracted by angiotensin II AT1-receptor blockade.
-
Acta Anaesthesiol Scand · Oct 2001
ReviewNerve blocks in chronic pain therapy--are there any indications left?
Although diagnostic imaging is now highly developed, neural blockade provides another opportunity to test for a source of pain that may frequently leave no signature. Likewise, many neuropathic pains can not be tested by neurodiagnostic methods. ⋯ In particular, the example of autonomic blocks and blocks of the axial spine are emphasized. Nerve blocks require an understanding of the anatomy, physiology, pharmacology, and the ability to interpret critically their results.
-
Acta Anaesthesiol Scand · Oct 2001
ReviewEvaluation and assessment of cancer pain and cancer pain treatment.
Evaluation and assessment are the first steps of any strategy for the management of cancer pain, and are fundamental for any clinical research project in this field. Different clinical systems for evaluation and classification of cancer pain syndromes are available and their clinical usefulness should be tested. ⋯ Specific questions arise when these tools are used in long-term repeated assessments of cancer patients. Assessment and measuring techniques deserve more investigations to optimize standard valid procedures and to enable us to exchange clinical information and produce comparable data in research.
-
Acta Anaesthesiol Scand · Oct 2001
Comparative Study Clinical TrialSymptom recognition in advanced cancer. A comparison of nursing records against patient self-rating.
The aim of the study was to investigate the extent to which the symptoms experienced by advanced cancer patients were covered by the nursing records. On the day of the first contact with our palliative care department, a nursing record was taken, and on this or the following day, 56 patients filled in the questionnaires EORTC Quality of Life Questionnaire (EORTC QLQ-C30), Edmonton Symptom Assessment System (ESAS), and Hospital Anxiety and Depression Scale (HADS). ⋯ Reasons for these discrepancies are discussed. It is suggested that the nurse's knowledge of the patient's symptomatology might gain from more systematic screening or from transfer of information from patient self-assessment questionnaires to the nursing records.
-
Acta Anaesthesiol Scand · Oct 2001
Hemodynamic and sympathetic effects of fenoldopam and sodium nitroprusside.
Fenoldopam is a novel dopamine-1 receptor selective agonist that can be used as a vasodilator perioperatively to treat hypertension and to produce induced hypotension. We were interested to find out whether there were any differences between fenoldopam (FM) and sodium nitroprusside (SNP), one of the most popular vasodilators, in their effects on hemodynamics and sympathetic outflow using not only neuraxis intact but also baro-denervated animal models. ⋯ Unlike sodium nitroprusside, fenoldopam attenuates both cardiac (heart rate) and sympathetic baroreflex sensitivity, which may explain the lack of rebound hypertension with fenoldopam. The offset of hypotensive effects of fenoldopam is a significantly slower process as compared to nitroprusside, and this may be an unfavorable feature of fenoldopam should overshoot of hypotension occur.