Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2003
Randomized Controlled Trial Comparative Study Clinical TrialComparison of different concentrations of levobupivacaine for post-operative epidural analgesia.
The relative effects of the mass, volume and concentration of local anaesthetic solution used for epidural anaesthesia and analgesia are still under debate. Clinical studies have shown discrepancies, probably because of limited consideration of total dose. ⋯ The same dose of levobupivacaine provides an equal quality of analgesia in low or high volume continuous thoracic epidural infusion with reduced haemodynamic instability and nausea in the low volume/high concentration groups.
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Acta Anaesthesiol Scand · Aug 2003
Case ReportsCardiac arrest after interscalene brachial plexus block with ropivacaine and lidocaine.
Serious adverse reactions to ropivacaine and lidocaine are rare. In this report, we describe a case of sudden cardiac arrest after an interscalene brachial plexus block with a mixture of 150 mg of ropivacaine and 360 mg of lidocaine in a previously healthy, 34-year-old, 97-kg man. ⋯ He eventually made a good recovery. We conclude that although ropivacaine and lidocaine are often considered relatively safe local anesthetics, serious cardiovascular complications can occur after the use of these drugs.
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Acta Anaesthesiol Scand · Aug 2003
Case ReportsLow utilisation of unactivated protein C in a patient with meningococcal septic shock and disseminated intravascular coagulation.
Activated protein C has recently been shown in a multicentre trial to significantly reduce mortality in patients with septic shock. There are also some case reports and minor studies demonstrating promising results with the unactivated form of protein C. However, in children with severe meningococcal infection, skin biopsies have demonstrated low expression of endothelial thrombomodulin and protein C receptors, suggesting low protein C activation capacity in severe meningococcal sepsis. ⋯ The result indicates that whole body utilisation of the unactivated protein C was low. Endothelial impairment of protein C activation does not seem to be restricted to the skin vessels only.
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Acta Anaesthesiol Scand · Aug 2003
Randomized Controlled Trial Comparative Study Clinical TrialDexamethasone is as effective as ondansetron for the prevention of postoperative nausea and vomiting following breast surgery.
Postoperative nausea and vomiting remain a common problem following breast surgery. This study assesses whether dexamethasone is as effective as ondansetron in the control of postoperative nausea and vomiting (PONV). ⋯ Ondansetron 4 mg or dexamethasone 4 mg are equally effective in the prevention of postoperative nausea and vomiting following breast surgery. Other factors being similar, the difference in cost between these drugs would favor the use of dexamethasone instead of ondansetron when monotherapy against PONV is used.