Acta anaesthesiologica Scandinavica
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This editorial accompanied the 2004 study from Ekman, the first published evidence showing a reduction in awareness when BIS monitoring is used to monitor depth of anaesthesia.
Ekman’s findings were shortly after confirmed by Myles et al. in their landmark 2004 B-Aware Trial.
This editorial and the two related studies are well worth reading to give historical context to the emergence of reliable depth-of-anaesthesia monitors.
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Acta Anaesthesiol Scand · Jan 2004
Case Reports Clinical TrialReduction in the incidence of awareness using BIS monitoring.
Explicit recall (ER) is evident in approximately 0.2% of patients given general anaesthesia including muscle relaxants. This prospective study was performed to evaluate if cerebral monitoring using BIS to guide the conduction of anaesthesia could reduce this incidence significantly. ⋯ The use of BIS monitoring during general anaesthesia requiring endotracheal intubation and/or muscle relaxants was associated with a significantly reduced incidence of awareness as compared with a historical control population.
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Acta Anaesthesiol Scand · Jan 2004
Pulmonary inflammatory mediators after sevoflurane and thiopentone anaesthesia in pigs.
Volatile anaesthetics have been shown to affect the release of pulmonary inflammatory mediators and exacerbate pulmonary injury after experimental aspiration. Thus, in theory, volatile anaesthetics may worsen inflammatory pulmonary injury and disease. We have previously described that no significant changes in alveolar ultrastructure are seen after sevoflurane anaesthesia. However, this does not exclude any possible physiological alterations. The aim of our study was to evaluate pulmonary inflammatory mediators in bronchoalveolar lavage (BAL) after sevoflurane and thiopentone anaesthesia in pigs with intact lungs. ⋯ We conclude that sevoflurane increases pulmonary LTC4, NO3-, and NO2- production in pigs, indicating an inflammatory response.
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Acta Anaesthesiol Scand · Jan 2004
Case ReportsPneumomediastinum in labour -- probably not caused by a lumbar epidural anaesthesia.
We describe a case of pneumomediastinum and subcutaneous emphysema during labour. The patient had previously received an epidural anaesthesia to alleviate labour pain. We found several reports of subcutaneous emphysema and pneumomediastinum (or pneumothorax) possibly caused by or related to epidural anaesthesia use, but conclude that the epidural anaesthesia was probably not a cause in our case.
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Acta Anaesthesiol Scand · Jan 2004
Randomized Controlled Trial Clinical TrialPropofol and remifentanil for intubation without muscle relaxant: the effect of the order of injection.
Common practice in intubation without muscle relaxant is to inject the opioid drug prior to the hypnotic drug. Because remifentanil reaches adequate cerebral concentration more rapidly than does propofol, we tested the hypothesis that injection of remifentanil after propofol might lead to better intubating conditions. ⋯ We therefore conclude that in premedicated healthy patients with no anticipated risk of difficult intubation, intubating and haemodynamic conditions are better when remifentanil is injected after propofol.