Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2004
Randomized Controlled Trial Clinical TrialPreoperative stellate ganglion blockade prevents tourniquet-induced hypertension during general anesthesia.
Prolonged and excessive inflation of pneumatic tourniquets leads to a hyperdynamic circulatory response. Sympathomimetic activity is an important factor in tourniquet-induced hypertension. Stellate ganglion block specifically blunts sympathetic efferent nerves and prevents hypertension induced by sympathomimetic stimulation. The present study was performed to investigate the effects of stellate ganglion block (SGB) on arterial pressure and heart rate during prolonged tourniquet use under general anesthesia. ⋯ Ipsilateral SGB attenuated the hyperdynamic response mediated by prolonged tourniquet inflation during knee arthroscopy.
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Acta Anaesthesiol Scand · May 2004
Case Reports Comparative StudyPulmonary artery thermodilution cardiac output vs. transpulmonary thermodilution cardiac output in two patients with intrathoracic pathology.
In two adult patients, one with a severe hemorrhage and one with a partial anomalous pulmonary vein, cardiac output (CO) measurements were performed simultaneously by means of the bolus transpulmonary thermodilution technique (COao) and continuous pulmonary artery thermodilution method (CCOpa). In both cases, the methods revealed clinically significant different cardiac output values based upon the site of measurement and the underlying pathology. The assessment of cardiac output (CO) is considered an important part of cardiovascular monitoring of the critically ill patient. ⋯ Based on these results we assumed CCOpa equivalent to real CO during hemodynamically stable conditions, and secondly, a continuous cardiac output system based on pulse contour analysis (PCCO), such as the PiCCO system (Pulsion Medical System, Munchen, Germany). To calibrate this device, which uses a derivation of the algorithm of Wesseling and colleagues, an independently obtained value of CO by the transpulmonary thermodilution method (COao) is used. Clinical validation studies in patients without underlying intrathoracic pathology, comparing transpulmonary COao with the pulmonary technique (COpa), mostly yielded good agreement.
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Acta Anaesthesiol Scand · May 2004
Rapid response car as a supplement to the helicopter in a physician-based HEMS system.
The purpose of this study was to describe the use of a rapid response car (RRC) as a supplement to the ambulance helicopter in a mixed urban/rural region in Norway. ⋯ The RRC was essential for solving missions in periods of non-flying conditions. The RRC increased the availability of the advanced prehospital life support offered by the HEMS in this region. Taking the modest increase in cost into consideration, it seems reasonable that this HEMS, covering mixed urban and rural areas, is equipped with such a vehicle.
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Acta Anaesthesiol Scand · May 2004
Letter Case ReportsThe use of gabapentin in a 12-year-old boy with cancer pain.
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Acta Anaesthesiol Scand · May 2004
Randomized Controlled Trial Comparative Study Clinical TrialHigh-dose bupivacaine, levobupivacaine and ropivacaine in axillary brachial plexus block.
Racemic bupivacaine is clinically similar to levobupivacaine, or ropivacaine. The drugs were compared in brachial plexus block for the first time in the same randomized and double-blind study. ⋯ Ropivacaine-HCl 5 mg ml(-1) produced slightly better sensory and motor block intensity than the same dose of levobupivacaine-HCl. General success in relation to surgery and in the duration of the blocks was similar in the three groups.