Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2004
Adrenaline administration during cardiopulmonary resuscitation: poor adherence to clinical guidelines.
Adrenaline does not appear to improve the outcome after cardiac arrest in clinical trials in spite of beneficial effects in experimental studies. The objective of this study was to determine whether adrenaline was administered in accordance with advanced cardiac life support (ACLS) guidelines during adult cardiopulmonary resuscitation (CPR). ⋯ In the majority of cases adrenaline did not appear to be administered according to current ACLS guidelines.
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Acta Anaesthesiol Scand · Aug 2004
Randomized Controlled Trial Clinical TrialChanges in cerebral oxygenation during cold (28 degrees C) and warm (34 degrees C) cardiopulmonary bypass using different blood gas strategies (alpha-stat and pH-stat) in patients undergoing coronary artery bypass graft surgery.
Impaired cerebral oxygenation, which is reflected by measuring jugular bulb oxygenation, is thought to play an important role in the development of neurological injury after cardiac operations with cardiopulmonary bypass (CPB). The effects of cardiopulmonary temperature and blood gas strategy on cerebral oxygenation are not fully appreciated. ⋯ Cold CPB failed to offer any further brain protection in terms of better preservation of cerebral oxygenation than warm CPB. Therefore, warm CPB (34 degrees C) with different blood gas strategies appears to be a satisfactory alternative to cold CPB (28 degrees C).
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Acta Anaesthesiol Scand · Aug 2004
Randomized Controlled Trial Clinical TrialNitrous oxide increases the incidence of bowel distension in patients undergoing elective colon resection.
Nitrous oxide rapidly inflates gas-filled spaces such as the intestines; but whether the resulting bowel distension is clinically important remains unclear. We therefore tested the hypothesis that nitrous oxide produces clinically important bowel distension. ⋯ Our results suggest that avoiding nitrous oxide administration during prolonged bowel operations will minimize bowel distension and possibly reduce postoperative pain related to it.
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Acta Anaesthesiol Scand · Aug 2004
Randomized Controlled Trial Clinical TrialIntrathecal morphine provides effective and safe analgesia in children after cardiac surgery.
The purpose of this prospective, randomized, blinded to observer study was to assess the analgesic effect and safety of intrathecal morphine (ITM) in post-operative pain control in children after heart surgery with a sternotomy incision. ⋯ An ITM dose of 20 micrograms/kg had a significant (P = 0.03) intravenous morphine-sparing effect after cardiac surgery. Effective analgesia was observed for 12 h after administration of intrathecal morphine.
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Acta Anaesthesiol Scand · Aug 2004
Randomized Controlled Trial Clinical TrialIs a double-injection technique superior to a single injection in posterior subgluteal sciatic nerve block?
Currently, no information is available on the effects of a double-injection technique on onset time and efficacy following subgluteal sciatic nerve blockade. We hypothesized that the success rate and time to onset of subgluteal nerve block following a double-injection technique would be superior to that after a single injection. ⋯ Both the single- and double-injection technique for subgluteal sciatic nerve blockade resulted in acceptable anesthesia in most patients. The double injection generated a faster onset of anesthesia than the single injection. However, the double-injection technique caused more patient discomfort during establishment of the nerve block.