Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2001
Randomized Controlled Trial Comparative Study Clinical TrialIntraocular pressure and ropivacaine in peribulbar block: a comparative study with bupivacaine.
The aim of this study was to compare the effects on intraocular pressure (IOP) of ropivacaine and bupivacaine in peribulbar block. ⋯ Ropivacaine 1.0% associated with hyaluronidase in peribulbar block is better than 0.75% bupivacaine under the same standard conditions for lowering IOP in intraocular surgery. This effect is probably due to relaxation of the extraocular muscles after the block with both anesthetics, and possibly to a smaller intraocular blood volume due to vasoconstriction in the case of ropivacaine.
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Acta Anaesthesiol Scand · May 2001
Randomized Controlled Trial Clinical TrialEffect of preincisional ilioinguinal and iliohypogastric nerve block on postoperative analgesic requirement in day-surgery patients undergoing herniorrhaphy under spinal anaesthesia.
By choosing spinal anaesthesia instead of general anaesthesia, and by infiltrating the wound area with local anaesthetic the need for postoperative analgesics may be reduced. An ilioinguinal and iliohypogastric nerve block (IINB) in inguinal herniorrhaphy was, therefore, studied in a day surgery setting in combination with a spinal block. ⋯ It is concluded that no long-term analgesia could be demonstrated by a preincisional IINB performed during spinal anaesthesia in day-surgery inguinal herniorrhaphy patients. Thus, reduced analgesic requirement was seen only for about 6 h postoperatively.
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Acta Anaesthesiol Scand · May 2001
Randomized Controlled Trial Comparative Study Clinical TrialSimilar haemodynamic, respiratory and metabolic changes with the use of sevoflurane or halothane in children breathing spontaneously via a laryngeal mask airway.
In preschool children, short-lasting surgical procedures are often performed under combined inhalational and regional anaesthesia with the child breathing spontaneously via a laryngeal mask airway (LMA). Despite widespread use, only limited data are available on haemodynamic, respiratory and metabolic effects of sevoflurane and halothane during LMA anaesthesia. ⋯ The use of approximately 1 MAC sevoflurane or halothane in 60% N2O in children breathing spontaneously via LMA resulted in comparable haemodynamic, respiratory and metabolic changes, and clinically relevant deteriorations did not occur during the 65-min study period.
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Acta Anaesthesiol Scand · May 2001
Randomized Controlled Trial Clinical TrialHaemodynamic changes and vasopressin release are not consistently associated with carbon dioxide pneumoperitoneum in humans.
Conflicting haemodynamic changes, suggested to be caused by vasopressin release, have been reported during carbon dioxide (CO2) pneumoperitoneum. However, peritoneal stimulations including open surgery cause both a systemic vasopressor response and a vasopressin release, which are suppressed by opiate administration. Also, a decreased venous return of blood to the heart causes vasopressin release. Furthermore, previous haemodynamic assessments of laparoscopic surgery have been conducted using various anaesthetic regimens, which are likely to have caused various haemodynamic effects. We hypothesised that intraoperative haemodynamic and/or humoral changes would not be observed in association with laparoscopic surgery provided that, (a) normovolaemia is continuously maintained using transoesophageal echocardiographic (TEE) assessment, and (b) adequate depth of general anaesthesia is continuously maintained by bispectral index (BIS) monitoring and high plasma Ievel opiate administration. ⋯ Continuous adequate depth of anaesthesia and normovolaemia may have prevented both a humoral and a haemodynamic response, initiated in the peritoneum by the contact with CO2 in previous investigations.
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Acta Anaesthesiol Scand · May 2001
Case ReportsLaryngeal papillomatosis with airway obstruction in an infant.
Laryngeal papillomatosis in infants and children is a benign condition, but the location and a marked tendency for recurrence makes the disease both dangerous and troublesome. This case report deals with a little girl who had suffered hoarseness and wheezing since she was born. The diagnosis of laryngeal papillomatosis was made when she was 17 months old. ⋯ Laser treatment and anaesthetic management of small children with a compromised airway are discussed. As tracheal intubations and tracheotomy increase the risk of the disease spreading to the trachea and bronchi, an example is given of treating laryngeal papillomatosis with potassium titanyl phosphate (KTP) laser, using a laryngeal mask as an airway to avoid tracheal intubation. Whether this procedure can reduce the need to perform a tracheotomy in some of these small patients remains to be seen.