Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2004
Randomized Controlled Trial Clinical TrialContinuous popliteal sciatic nerve block for outpatient foot surgery--a randomized, controlled trial.
A major problem in outpatient foot surgery is severe postoperative pain that is not sufficiently treated by peroral analgesics. ⋯ This randomized, double-blind study shows that continuous blockade of the sciatic nerve in the popliteal fossa reduces postoperative pain and has no untoward effects in a patient group known to experience severe pain after ambulatory surgery.
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Acta Anaesthesiol Scand · Mar 2004
Randomized Controlled Trial Clinical TrialDesflurane-remifentanil-nitrous oxide anaesthesia for abdominal surgery: optimal concentrations and recovery features.
Intraoperative combinations of volatile and opioid agents are used to achieve unconsciousness, hypnotic sparing, haemodynamic stability and uneventful recovery. This study describes the influence of different remifentanil concentrations on these variables when combined with desflurane during abdominal surgery. ⋯ Remifentanil target concentrations from 3 to 15 ng ml(-1) had little influence on desflurane requirements or postoperative morphine consumption, but markedly modified intraoperative haemodynamic stability, suggesting that the target concentration should closely follow the successive noxious stimulations.
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Acta Anaesthesiol Scand · Mar 2004
Comparative StudyAccuracy in estimating the correct intervertebral space level during lumbar, thoracic and cervical epidural anaesthesia.
Even in the absence of factors concealing anatomical landmarks, high failure rates in correctly determining a given lumbar interspace have been reported. ⋯ As previously conjectured only for the lumbar region, we could confirm the tendency of anaesthetists to perform neuraxial puncture more cranially than expected also for the thoracic and cervical regions. The large majority of punctures (93.7%) was performed within one interspace of the predicted level.
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Acta Anaesthesiol Scand · Mar 2004
Comparative StudyPressure-volume relationships in acute lung injury: methodological and clinical implications.
Pressure-volume relationships (PV curves) are the only available method for bedside monitoring of respiratory mechanics. Alveolar recruitment modifies the results obtained from the PV curves. We hypothesized that method-related differences may influence PV-curve guided ventilatory management. ⋯ Pressure-volume curves obtained using variable PEEP translate a different physiological reality and seem to be clinically more relevant than curves constructed at constant PEEP. If curves constructed at constant PEEP are used to set the ventilator, unnecessarily high PEEP levels may be used. Respiratory inductive plethysmography technology may be used for monitoring of recruitment at the bedside.
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Acta Anaesthesiol Scand · Mar 2004
Comparative StudyPredictive value of mechanomyography and accelerometry for pulmonary function in partially paralyzed volunteers.
Accelerometry (ACM) of adductor pollicis muscle has been used for monitoring of neuromuscular blockade but its validity compared with the gold standard, mechanomyography (MMG), has been questioned. During neuromuscular blockade we compared these methods and we assessed pulmonary function. ⋯ Accelerometry predicts effects of relaxation on pulmonary function as valid as the gold standard mechanomyography. We recommend that recovery of TOF ratio to 0.9-1.0 should be used as an indication of sufficient neuromuscular recovery in daily practice.