Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 2002
Case ReportsRepeat cesarean section in a morbidly obese parturient: a new anesthetic option.
Combined spinal epidural anesthesia (CSEA) has become an increasingly popular anesthetic technique for repeat cesarean section. However, the advantages of this technique have not routinely been available to morbidly obese patients because of the lack of an appropriately long needle. We present a case of a morbidly obese parturient who underwent repeat cesarean section under CSEA conducted with the recently introduced (and commercially available) CSEA needle set, specifically designed for morbidly obese patients.
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Acta Anaesthesiol Scand · Jul 2002
Randomized Controlled Trial Clinical TrialIntraocular pressure more reduced during anesthesia with propofol than with sevoflurane: both combined with remifentanil.
Short-acting anesthetic agents are suitable and commonly used in ocular surgery. Propofol and remifentanil are known to reduce intraocular pressure (IOP), but no information is available regarding the effects of sevoflurane combined with remifentanil on IOP. ⋯ In patients undergoing cataract surgery under general anesthesia with tracheal intubation, anesthetic regimens with propofol as well as with sevoflurane, both combined with remifentanil, decrease IOP significantly. The decrease in IOP was significantly more pronounced in the propofol group than in the sevoflurane group.
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Acta Anaesthesiol Scand · Jul 2002
ReviewSmall-volume resuscitation: from experimental evidence to clinical routine. Advantages and disadvantages of hypertonic solutions.
The concept of small-volume resuscitation (SVR) using hypertonic solutions encompasses the rapid infusion of a small dose (4 ml per kg body weight, i.e. approximately 250 ml in an adult patient) of 7.2-7.5% NaCl/colloid solution. Originally, SVR was aimed for initial therapy of severe hypovolemia and shock associated with trauma. ⋯ Small-volume resuscitation by means of hypertonic NaCl/colloid solutions stands for one of the most innovative concepts for primary resuscitation from trauma and shock established in the past decade. Today the spectrum of potential indications involves not only prehospital trauma care, but also perioperative and intensive care therapy.
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Acta Anaesthesiol Scand · Jul 2002
Randomized Controlled Trial Comparative Study Clinical TrialImproved long-lasting postoperative analgesia, recovery function and patient satisfaction after inguinal hernia repair with inguinal field block compared with general anesthesia.
Inguinal hernia repair is a common surgical procedure, and different types of anesthetic techniques are in use. We wanted to test if preoperative inguinal field block (IFB) with ropivacaine would provide benefits in the postoperative period compared with general anesthesia and wound infiltration. ⋯ Preoperative inguinal field block for hernia repair provides benefits for patients in terms of faster recovery, less pain, better mobilization and higher satisfaction throughout the whole first postoperative week.
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Acta Anaesthesiol Scand · Jul 2002
Clinical TrialPlasma cholinesterase activity and duration of action of mivacurium in phenotypically normal patients.
The short duration of action of mivacurium is due to its rapid hydrolysis by plasma cholinesterase (pChe). In patients with normal phenotype, low pChe activity because of, for instance, disease or intake of drugs may prolong the duration of action of mivacurium. The purpose of this study was to evaluate the relationship between pChe activity and the duration of action of mivacurium 0.2 mg/kg in phenotypically normal patients. ⋯ In patients with phenotypically normal pChe, prediction of the duration of action of mivacurium is possible from the patients actual pChe activity. In patients with pChe activities below the normal range, the time to reappearance of the first response to TOF stimulation may vary from 10 to 180 min Only patients with pChe activities <220 U/l had a significantly prolonged duration of action of mivacurium.