Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2003
Randomized Controlled Trial Clinical TrialThe effects of hydroxyethyl starch solutions on thromboelastography in preoperative male patients.
Hydroxyethyl starches (HES) have been shown to decrease clot strength and to increase coagulation times assessed by thromboelastography (TEG). HES with minimal anticoagulant side-effects is beneficial for plasma volume expansion in the perioperative setting. A comparison of the in vivo effects of high, middle and low molecular weight HES solutions on TEG variables has not been performed so far. ⋯ Infusion of HES 450/0.7/4.6 compromises TEG parameters more than the other solutions tested, whereas HES 130/0.4/9 has the smallest effect. Further outcome-related studies are needed in order to assess the clinical relevance of our findings.
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Acta Anaesthesiol Scand · Jan 2003
Randomized Controlled Trial Clinical TrialClinical trial of esmolol-induced controlled hypotension with or without acute normovolemic hemodilution in spinal surgery.
Drug-induced controlled hypotension (CH) combined with acute normovolemic hemodilution (ANH) is being widely used for blood conservation in surgical patients. The purpose of this study was to investigate the efficacy and safety of esmolol-induced CH combined with ANH (hematocrit down to 28%). ⋯ Our data suggest that ANH of moderate degree can be combined with esmolol-induced CH to improve blood conservation in surgical patients.
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Acta Anaesthesiol Scand · Jan 2003
Case ReportsFunctional improvement after physiotherapy with a continuous infusion of local anaesthetics in patients with complex regional pain syndrome.
Three patients were referred to our pain clinic with evidence of complex regional pain syndrome in their extremities. Two presented at the atrophic stage with joint contractures. Multiple analgesics had been prescribed without long-lasting relief. ⋯ We instituted local anaesthetic infusion with the possibility of self-supplementation to facilitate physiotherapy; two via brachial plexus catheters for hand pain and one via epidural catheter for knee pain. Although their resultant pain scores were variable after cessation of local anaesthetic infusion, all the affected joints exhibited marked improvement in range of movement. We propose that this technique is a useful option for patients in all stages of complex regional pain syndrome where the emphasis is now directed toward functional improvement.
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Acta Anaesthesiol Scand · Jan 2003
Effects of acute normovolemic hemodilution on ventriculoarterial coupling in dogs.
Acute normovolemic hemodilution (ANH) causes a decrease in systemic vascular resistance. Similar to vasodilating drugs, ANH might modify ventriculoarterial coupling. Left ventricular elastance (Ees), effective arterial elastance (Ea), stroke work (SW), and pressure volume area (PVA) were used as indicators to examine the effects of ANH on this coupling. ⋯ Before ANH, ventriculoarterial coupling was so matched as to maximize SW at the expense of the work efficiency. This relation was preserved at ANH50.
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Acta Anaesthesiol Scand · Jan 2003
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the catheter-technique psoas compartment block and the epidural block for analgesia in partial hip replacement surgery.
The aim of this study was to compare the intra- and postoperative analgesia provided by the catheter-technique psoas compartment block and the epidural block in hip-fractured patients. We also compared hemodynamic stability, motor blockade, ease of performing the technique, and complications. ⋯ The continuous psoas compartment block provides excellent intraoperative and postoperative analgesia with a low incidence of complications for partial hip replacement surgery