Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2004
Dobutamine compensates deleterious hemodynamic and metabolic effects of vasopressin in the splanchnic region in endotoxin shock.
Vasopressin is a potent vasopressor in septic shock, but it may impair splanchnic perfusion. We compared the effects of vasopressin alone and in combination with dobutamine on systemic and splanchnic circulation and metabolism in porcine endotoxin shock. ⋯ Dobutamine prevents adverse hemodynamic and metabolic effects of vasopressin in septic shock.
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Acta Anaesthesiol Scand · Sep 2004
Residents lack knowledge and practical skills in handling the difficult airway.
Full-scale simulators have been developed in anaesthesia. We aimed at assessing Danish anaesthesia residents' knowledge and management of a standardized difficult airway situation in an advanced airway simulator. The reliability of the assessment was also determined. ⋯ Theoretical and practical education in difficult airway management needs to be improved among Danish anaesthesia residents. Simulator assessment should only be performed using well-defined objective parameters and trained assessors.
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Acta Anaesthesiol Scand · Sep 2004
Case ReportsTerlipressin increased the concentration of L-lactate in the rectal lumen in a patient with septic shock.
Terlipressin--a long-acting analogue of vasopressin--has been described to restore blood pressure in patients with catecholamine-resistant septic shock without obvious complications. We administered low-dose terlipressin (a single i.v.-bolus of 0.5 mg) to a patient with severe, hyperdynamic septic shock requiring high dosage of noradrenalin. After terlipressin the dose of noradrenalin could be reduced by 2/3 to obtain the same blood pressure. ⋯ In contrast, the systemic concentration of L-lactate was unaffected around 2.8 mmol l(-1). After 8 h the effect of terlipressin started to decline, and after an additional 12 h the systemic haemodynamics, dose of noradrenalin and concentrations of rectal and systemic L-lactate were the same as prior to the administration of terlipressin. As a strong vasopressor, terlipressin may have further impaired the metabolic dysfunction in the rectal mucosa either directly via vasoconstriction of mucosal vessels or through decreased cardiac output in this patient with noradrenalin-treated septic shock.
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Acta Anaesthesiol Scand · Sep 2004
Scandinavian research in anaesthesiology 1981-2000: visibility and impact in EU and world context.
We wished to assess the development in number and impact of publications in anaesthesiology and intensive care medicine from 1981 to 2000 in the four Scandinavian countries: Sweden, Norway, Finland, and Denmark. For comparison, we also analyzed data from the UK and the Netherlands. ⋯ (1) The annual number of publications from Sweden, Norway, Finland, the UK, and the Netherlands increased after the late eighties, whereas the net publication output from Denmark was stagnant over the 20-year period investigated; (2) the international publication and citation visibility of Finland and Norway increased slightly, as opposed to the significant decrease seen by the other four countries; (3) judging from the increase in absolute and relative citation impact and in the percentage of cited papers, the recognition of publications from the four Scandinavian countries increased over the past 20 years.
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Acta Anaesthesiol Scand · Sep 2004
Randomized Controlled Trial Clinical TrialAnalgesic effects of preincisional administration of dextromethorphan and tenoxicam following laparoscopic cholecystectomy.
Pre-incisional treatment with either N-methyl-D-aspartate (NMDA) receptor antagonists or non-steroidal anti-inflammatory drugs (NSAIDs) improves postoperative pain relief. This study examines the effect on postlaparoscopic cholecystectomy (LC) pain of a combination of dextromethorphan (DM), a NMDA-receptor antagonist, and tenoxicam, a NSAID, given preoperatively. ⋯ The results suggest that pretreatment with DM, but not tenoxicam, provides significant pre-emptive analgesia for postoperative pain management in patients after LC surgery. Combining DM and tenoxicam also gives good pain relief.