Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2002
Clinical TrialCerebral blood flow, oxidative metabolism and cerebrovascular carbon dioxide reactivity in patients with acute bacterial meningitis.
The optimal arterial carbon dioxide tension (P(a)CO(2)) in patients with acute bacterial meningitis (ABM) is unknown and controversial. The objective of this study was to measure global cerebral blood flow (CBF), cerebrovascular CO(2) reactivity (CO(2)R), and cerebral metabolic rates (CMR) of oxygen (O(2)), glucose (glu), and lactate (lac), in patients with ABM and compare the results to those obtained in healthy volunteers. ⋯ In patients with acute bacterial meningitis, we found variable levels of CBF and cerebrovascular CO(2) reactivity, a low a-v DO(2), low cerebral metabolic rates of oxygen and glucose, and a cerebral lactate efflux. In these patients, a ventilation strategy guided by jugular bulb oximetry and/or repeated CBF measurements may be more optimal in terms of cerebral oxygenation than a strategy aiming at identical levels of P(a)CO(2) for all patients.
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Acta Anaesthesiol Scand · May 2002
Randomized Controlled Trial Clinical TrialThe pharmacodynamics and pharmacokinetics of mivacurium in children.
In children, onset time and duration of action of mivacurium are shorter than in adults. Some suggest that this is due to differences in plasma cholinesterase (pChe), whereas others indicate that there is no difference. The purpose of this study was to evaluate the pharmacodynamics and pharmacokinetics of mivacurium in phenotypically normal children aged 3-6 and 10-14 years old, respectively. ⋯ Our data indicate that there are no major differences in pharmacodynamics or pharmacokinetics of mivacurium between young (3-6 years) and older (10-14 years) children.
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Acta Anaesthesiol Scand · May 2002
Randomized Controlled Trial Clinical TrialSevoflurane requirements during ambulatory surgery: a clinical study with and without AEP-index guidance.
Several monitors have been developed to measure anesthetic depth. The auditory evoked response uses an auditory signal to actively test the level of brain activity. The aim of the present study was to determine whether sevoflurane titration with A-line auditory guidance from the evoked potential monitor would reduce gas consumption and improve recovery times. ⋯ The auditory evoked potential index provided by the A-line monitor does not decrease sevoflurane consumption or emergence times for ambulatory knee arthroscopy.
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Acta Anaesthesiol Scand · May 2002
Case ReportsAltered response to intravenous thiopental and succinylcholine in acute amphetamine abuse.
Substance abuse has become increasingly prevalent: illegal drugs have profound and varied physiologic effects which create a large potential for anesthetic problems and complications (1). Amphetamine is a strong sympathomimetic and may therefore influence the course of anesthesia. We report the case of a patient with acute amphetamine abuse presenting difficulties during anesthesia.
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Acta Anaesthesiol Scand · May 2002
Clinical TrialEffect of CO(2) pneumoperitoneum on ventilation-perfusion relationships during laparoscopic cholecystectomy.
Previous studies have shown that pneumoperitoneum transiently reduces venous admixture as assessed by a calculation based on the shunt formula, and increases arterial oxygen tension (PaO(2)) in patients without heart or lung disease. The aim of the present study was to further explore the relationship between ventilation-perfusion (V(A)/Q) before and during pneumoperitoneum by using the multiple inert gas technique. ⋯ In patients without heart or lung disease, pneumoperitoneum at an intra-abdominal pressure level of 11-13 mmHg causes a transient reduction of the pulmonary shunt. The mechanisms underlying the present finding remain to be elucidated.