Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2003
Randomized Controlled Trial Clinical TrialThe effect of nitrous oxide on cerebral blood flow velocity in children anesthetized with propofol.
Propofol for maintenance of anesthesia by continuous infusion is gaining popularity for use in pediatric patients. Nitrous oxide (N2O) has been shown to increase cerebral blood flow velocity (CBFV) in both children and adults. To determine the effects of N2O on middle cerebral artery blood flow velocity (Vmca) during propofol anesthesia in children, Vmca was measured with and without N2O using transcranial Doppler (TCD) sonography. ⋯ The effects of nitrous oxide on CBFV are preserved in children during propofol anesthesia.
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Acta Anaesthesiol Scand · Mar 2003
Randomized Controlled Trial Clinical TrialCatecholamine release during laparoscopic fundoplication with high and low doses of remifentanil.
Reports on stress responses to laparoscopic surgery have been conflicting. Depth of anesthesia may influence the neuro-hormonal release, including catecholamines. Opioids depress general sympathetic activation in a dose-dependent manner. We investigated the hypothesis that remifentanil would depress the catecholamine response to pneumoperitoneum and laparoscopic surgery differently with a high dose (HD) compared with a low dose (LD). ⋯ High dose of remifentanil depressed the epinephrine response to pneumoperitoneum and surgery, indicating no general activation of the sympathetic nervous system. Neither a LD nor HD of remifentanil depressed the norepinephrine response during pneumoperitoneum. This suggests a centrally independent release of norepinephrine.
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Acta Anaesthesiol Scand · Mar 2003
Multiple organ failure and outcome of critically ill patients with haematological malignancy.
The number of failing organs systems in ICU patients with haematological malignancy is associated with outcome. The objective of this study was to assess short and long-term survival in these patients with special reference to multiple organ failure reflected by the SOFA (Sequential Organ Failure Assessment) score. ⋯ Multiple organ failure assessed as SOFA score on admission and status of disease were associated with outcome in critically ill patients with haematological malignancy.
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Retrograde intubation has been accepted internationally as a viable alternative for managing the difficult airway. Various techniques have been described to perform this procedure, however, difficulties have arisen on account of problems with suboptimal materials. We therefore describe a retrograde intubation technique using the knife and stiff plastic introducer from a Mini-Trach II set from Portex Ltd (Kent, UK). ⋯ Retrograde intubation with a stiff curved plastic introducer was rapid and easy in cadavers and in four patients. In emergency situations where conventional intubation fails it may be life saving.
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Acta Anaesthesiol Scand · Mar 2003
A new short-acting non-depolarizing muscle relaxant (SZ1677) without cardiovascular side-effects.
In order to facilitate rapid tracheal intubation, the development of a rapid onset, short duration, non-depolarizing muscle relaxant without cardiovascular side-effects would be a significant accomplishment in the field of anesthesiology. The aim of the present study was to test the action of a new non-depolarizing muscle relaxant (SZ1677) on neuromuscular transmission, muscarinic (M2, M3) receptors and cardiovascular reactions and to compare it with clinically used muscle relaxants. ⋯ In experiments, SZ1677 proved to be a short-acting neuromuscular blocking compound having a large safety margin between the doses required to produce neuromuscular block and those likely to lead to cardiovascular side-effects.