Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 2004
Clinical TrialTroponin T-values provide long-term prognosis in elderly patients undergoing non-cardiac surgery.
The aim of this study was to evaluate the significance of elevated postoperative Troponin T (TnT) levels in an elderly population undergoing non-cardiac surgery. ⋯ We conclude that elevated TnT levels in the postoperative period confer a 15-fold increase in mortality during the first year after surgery. Our findings also provide evidence that silent myocardial ischemia is common in an elderly population. Routine perioperative surveillance for TnT might therefore be of use in detecting patients at an increased risk of mortality during the first postoperative year.
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Acta Anaesthesiol Scand · Oct 2004
Randomized Controlled Trial Clinical TrialSupplemental remifentanil during coronary artery bypass grafting is followed by a transient postoperative cardiac depression.
The pharmacokinetic properties of the short-acting micro opioid receptor-agonist remifentanil makes it possible to give cardiac surgical patients a deep intraoperative anesthesia without experiencing postoperative respiratory depression and a prolonged stay in the intensive care unit (ICU). However, previous investigations have shown that patients who received remifentanil required additional analgesia during the early postoperative period as compared to patients who received fentanyl. The aim of the present study therefore was to investigate the effects of supplementing remifentanil to a standard fentanyl-based anesthesia in coronary artery bypass grafting (CABG). ⋯ In CABG, remifentanil reduces the hemodynamic and metabolic responses during surgery but seems to give a cardiac depression in the early postoperative phase.
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Acta Anaesthesiol Scand · Oct 2004
Randomized Controlled Trial Clinical TrialPropacetamol and diclofenac alone and in combination for analgesia after elective tonsillectomy.
Diclofenac and paracetamol have different mechanisms and sites of action. Therefore, we tested if their combination is more effective for analgesia after tonsillectomy than either drug alone with respect to rescue analgesic consumption and visual analog scale values. ⋯ Combined treatment with propacetamol and diclofenac with the dosages used provided clinically only a minor advantage over monotherapy with propacetamol or diclofenac with respect to postoperative analgesia or the incidence of side-effects in adult tonsillectomy patients.
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Acta Anaesthesiol Scand · Oct 2004
Clinical TrialPostoperative cognitive dysfunction: true deterioration versus random variation.
Postoperative cognitive dysfunction (POCD) is a common complication, especially in the elderly. The aim of this study was to describe how variability in neuropsychological testing could lead to the detection of cognitive improvement and poor consistency of POCD between postoperative test sessions. ⋯ Variability in neuropsychological test data contributes to a low consistency between postoperative test sessions but it does not explain the detection of cognitive dysfunction after major surgery.
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Acta Anaesthesiol Scand · Oct 2004
Comparative Study Clinical TrialComparison of BIS and AAI as measures of anaesthetic drug effect during desflurane-remifentanil anaesthesia.
Autoregressive modelling with exogenous input of the middle-latency auditory evoked potential has been developed for monitoring of anaesthetic depth. This study was designed to investigate the dose-response relationship between endtidal desflurane concentrations and the Alaris Autoregressive Index (AAI, Alaris Medical, Hampshire, UK, version 1.4) or the bispectral index (Aspect Medical Systems, Newton, MA, USA, version XP). ⋯ Changes of desflurane concentrations during deep anaesthesia were adequately displayed only in 16 of 21 cases by BIS but in none of the cases by AAI monitoring.