Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2001
Randomized Controlled Trial Clinical TrialRecovery profile and side effects of remifentanil-based anaesthesia with desflurane or propofol for laparoscopic cholecystectomy.
Nitrous oxide (N2O) has been suggested to contribute to bowel distension, resulting in worsened operating conditions for laparoscopic surgery, and to increase incidence of postoperative nausea and vomiting. Therefore, our objective was to assess the feasibility of two remifentanil-based anaesthetic regimens free from N2O with special regard to recovery profile, postoperative analgesic demand and side effects in patients undergoing laparoscopic cholecystectomy. ⋯ In patients undergoing laparoscopic cholecystectomy, remifentanil-based anaesthetic regimens in conjunction with propofol or desflurane are suitable and allow for rapid recovery from anaesthesia. However, the use of propofol results in less postoperative analgesic consumption and nausea as compared to desflurane.
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Acta Anaesthesiol Scand · Mar 2001
Case ReportsAirway pressure release ventilation and prone positioning in severe acute respiratory distress syndrome.
Implementation of lung protective strategy in the treatment of severe Acute Respiratory Distress Syndrome (ARDS) has been reported to be associated with improved outcome. To fulfil this approach, sedation, neuromuscular blocking agents and full mechanical ventilatory support are often used in critical failure of gas exchange. ⋯ APRV and maintenance of patients' spontaneous ventilation is feasible during prone positioning, and this approach may have beneficial synergistic effects on gas exhange in patients with severe acute lung injury.
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Bispectral index (BIS) monitoring has been found to decrease the requirements for propofol, sevoflurane and desflurane and to improve recovery. We wanted to assess the effect of BIS monitoring on intraoperative isoflurane utilisation, and the early recovery profile. ⋯ The addition of BIS to standard monitoring decreases isoflurane consumption. However, we found only a small advantage in using BIS with respect to recovery from isoflurane anaesthesia.
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Acta Anaesthesiol Scand · Mar 2001
Postoperative tracheal extubation after orthotopic liver transplantation.
The duration of postoperative mechanical ventilation and its influence on pulmonary function in liver transplant recipients is still debated controversially. ⋯ Immediate tracheal extubation was safe and well tolerated. The incidence of reintubation was not increased when compared to patients in whom extubation succeeded later. However, special attention should be given to transplant recipients presenting in reduced clinical condition at the time of OLT, undergoing complicated surgery, or receiving liver allografts with severe reperfusion injury because of an increased risk for prolonged mechanical ventilation.
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Acta Anaesthesiol Scand · Mar 2001
Management of anaphylactic shock evaluated using a full-scale anaesthesia simulator.
The diagnosis of an anaphylactic reaction during anaesthesia is not the first consideration for the anaesthetist and might be missed. The aim of this study was to describe anaesthetists' management of an anaphylactic reaction concerning diagnosing, treatment and application of anaesthesia crisis resource management (ACRM) in a full-scale anaesthesia simulator. ⋯ Anaphylactic shock was difficult to diagnose and no structured plans were used for the treatment in the simulated incident in this study.