Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Nov 2005
Randomized Controlled Trial Comparative StudyA comparison of the vertical infraclavicular and axillary approaches for brachial plexus anaesthesia.
This prospective, randomized study compared the efficacy of the vertical infraclavicular and axillary approaches using a single injection blockade of the brachial plexus. The primary endpoint was complete blockade in dermatomes C5-Th1, while secondary endpoints included onset time, motor block, block performance time, surgical success rate, patient satisfaction, and side-effects/complications. ⋯ The vertical infraclavicular approach provides a more complete block than the axillary approach when using a single injection technique and equal volumes/doses of local anaesthetic.
-
Acta Anaesthesiol Scand · Nov 2005
Randomized Controlled TrialIntra-operative remifentanil might influence pain levels in the immediate post-operative period after major abdominal surgery.
Remifentanil, a widely used analgesic agent in anaesthesia, has a rapid onset and short duration of action. In clinical settings, this requires an appropriate pain strategy to prevent unacceptable pain in the post-operative period. The aim of this study was to investigate whether remifentanil had any impact on post-operative pain and opioid consumption after major abdominal surgery. ⋯ The results are weak and difficult to interpret. They could indicate that a high dose of remifentanil added to otherwise sufficient combined general and epidural anaesthesia may induce opioid-induced hyperalgesia and/or clinically acute opioid tolerance after major abdominal surgery; however, as no significant differences could be observed between the groups after 2 h post-operatively, the clinical relevance of these observations is questionable.
-
Acta Anaesthesiol Scand · Nov 2005
Comparative Study Clinical TrialMonitoring urinary bladder volume and detecting post-operative urinary retention in children with an ultrasound scanner.
Post-operative urinary retention (PUR) is associated with a risk of over-distension and permanent detrusor damage. The prevention of PUR by routine catheterization may increase the risk of urinary tract infection. Post-operative monitoring of the bladder volume is a reliable method in adults, but has not been evaluated for reliability in children. ⋯ This study confirms agreement between the ultrasound scanner estimates of urinary bladder volume and the urine volume measured by emptying the bladder. Reliability was good in children above the age of 3 years. The volume was underestimated in younger children. Thus, routine monitoring of urinary bladder volume with an ultrasound scanner is a non-invasive, pain-free and reliable way of preventing over-distension of the urinary bladder in children after surgery and other procedures under general anaesthesia.
-
Acta Anaesthesiol Scand · Nov 2005
Clinical TrialThe cuff method: a pilot study of a new method of monitoring neuromuscular function.
A new method of monitoring neuromuscular blockade based on a modified blood pressure cuff that incorporates stimulating electrodes was compared with mechanomyography (MMG) ('gold standard'). ⋯ This pilot study indicates that the cuff method could be useful to monitor neuromuscular blockade according to the bias and limits of agreement compared with MMG, particularly when the degree of blockade was evaluated by TOF ratios > 0.7. The new cuff method is easy and simple to use. However, further studies in a larger number of patients are necessary to confirm these favourable preliminary results.
-
Acta Anaesthesiol Scand · Nov 2005
Analysis of multiple casualty incidents - a prospective cohort study.
Our aim was to report the rate and causes for multiple casualty incidents (MCI) to analyse the prehospital part of responding to MCIs, report mortality and find areas for improvement. ⋯ Traffic accidents, residential fires and intoxications were the leading causes for MCIs. Emergency medical service could respond to most MCIs efficiently and safely. Majority of deviations from standard medical care seemed potentially preventable. Several areas for improvement were identified. From prehospital links, the dispatching centre and on-scene medical command had a vital role in the successful management of MCIs.