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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Acta Anaesthesiol Scand · Mar 2003
Randomized Controlled Trial Comparative Study Clinical TrialIntrathecal hyperbaric bupivacaine 3 mg + fentanyl 10 microg for outpatient knee arthroscopy with tourniquet.
Combination of local anesthetic and opioid enables the use of less spinal anesthetic and increases the success of anesthesia. Intrathecal opioid does not prolong motor recovery and thus should not delay discharge home. We hypothesized that 3 mg of hyperbaric bupivacaine with 10 microg of fentanyl permits fast-tracking or shorter stay in post anesthesia care unit (PACU), and earlier discharge home, compared with 4 mg of hyperbaric bupivacaine. ⋯ Both solutions produced reliable spinal anesthesia for outpatient knee arthroscopy. The PACU-time was shorter in the bupivacaine-fentanyl group, but both groups reached home-readiness equally.
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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.