Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 2001
Studies on fluid extravasation related to induced hypothermia during cardiopulmonary bypass in piglets.
Hypothermia, commonly used for organ protection during cardiopulmonary bypass (CPB), has been associated with changes in plasma volume, hemoconcentration and microvascular fluid shifts. Fluid pathophysiology secondary to hypothermia and the mechanisms behind these changes are still largely unknown. In a recent study we found increased fluid needs during hypothermic compared to normothermic CPB. The aim of the present study was to characterize the distribution of the fluid given to maintain normovolemia. In addition, we wanted to investigate the quantity and quality of the fluid extravasated during hypothermic compared to normothermic CPB. ⋯ During hypothermic CPB an increased extravasation of fluid from the intravascular to the interstitial space was found. As no leakage of proteins could be demonstrated, based on stable values for albumin and protein masses throughout the experiments, the extravasated fluid contained mainly water and small solutes.
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Acta Anaesthesiol Scand · Jul 2001
Randomized Controlled Trial Clinical TrialCombination of droperidol and ondansetron reduces PONV after pediatric strabismus surgery more than single drug therapy.
Pediatric strabismus surgery is associated with a very high incidence of postoperative nausea and vomiting [(PONV) 44-88%]. Droperidol (10-75 microg kg(-1)) and ondansetron (50-150 microg kg(-1)) have shown variable success in reducing the incidence and severity of PONV. Combination of these two drugs has shown promising results. This randomized, double-blind, placebo-controlled clinical trial was conducted to evaluate the efficacy and safety of the combination of these two drugs in reducing the incidence and severity of PONV in pediatric strabismus surgery. ⋯ Droperidol 15 microg kg(-1) in combination with ondansetron 100 microg kg(-1), administered at the induction and end of the operative procedure respectively, is more effective than either drug given individually in reducing the incidence of PONV after strabismus surgery.
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Acta Anaesthesiol Scand · Jul 2001
Randomized Controlled Trial Clinical TrialFrequency of haemoglobin desaturation with the use of succinylcholine during rapid sequence induction of anaesthesia.
The perceived safety of the use of succinylcholine is based on the fact that recovery from its effects will occur before oxygen desaturation occurs in case of failure to intubate or ventilate. The purpose of this study was to examine the incidence of oxygen desaturation after the use of succinylcholine prior to resumption of spontaneous ventilation following four different preoxygenation techniques. ⋯ We conclude that use of succinylcholine may not always prevent desaturation if there is a failure to intubate and ventilate during a rapid sequence induction of anaesthesia.
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Acta Anaesthesiol Scand · Jul 2001
Randomized Controlled Trial Clinical TrialPostoperative analgesia by combined continuous infusion and patient-controlled epidural analgesia (PCEA) following hip replacement: ropivacaine versus bupivacaine.
Ropivacaine is a new local anaesthetic, which compared to bupivacaine is less toxic and shows greater sensory and motor block dissociation. We hypothesised that treatment of postoperative pain with a combined regimen of continuous epidural infusion and Patient-Controlled Epidural Analgesia (PCEA) using ropivacaine could have given better results compared with those we had obtained using bupivacaine. ⋯ Despite similar analgesic effects, epidural infusion of ropivacaine combined with PCEA provides higher patient satisfaction than equal doses of bupivacaine due to lack of motor block.
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Acta Anaesthesiol Scand · Jul 2001
Clinical TrialLack of agreement between thermodilution and carbon dioxide-rebreathing cardiac output.
A continuous, accurate, non-invasive monitor of cardiac output would represent a major step forward in patient management. A cardiac output computer, NICO2, based on the Fick principle and an automatic partial carbon dioxide (CO2)-rebreathing technique has just become available. We compared the performance of this monitor with the standard thermodilution method. ⋯ The agreement between the NICO2 derived cardiac output and the de facto standard - thermodilution cardiac output - is poor. The methods are not interchangeable with the present version of the NICO2. The repeatability of the partial CO2-rebreathing technique holds promise that a sufficient accuracy may be obtained by suitable modifications of the monitor's algorithms.