Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2005
Randomized Controlled Trial Comparative StudyIntrathecal clonidine does not reduce post-spinal shivering.
After general or epidural anesthesia, clonidine is known to be effective in suppressing established shivering. The aim of this study was to assess the preventive effect of intrathecal clonidine on post-spinal shivering compared with intravenous (i.v.) clonidine. ⋯ The intrathecal administration of clonidine 150 microg fails to prevent post-spinal shivering; by contrast, we have confirmed that i.v. clonidine 1 microg/kg is an effective method to prevent shivering in patients undergoing spinal anesthesia for orthopedic surgery.
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Acta Anaesthesiol Scand · Nov 2005
Randomized Controlled TrialThe effect of adding intrathecal magnesium sulphate to bupivacaine-fentanyl spinal anaesthesia.
The addition of intrathecal (IT) magnesium to spinal fentanyl prolongs the duration of spinal analgesia for vaginal delivery. In this prospective, randomized, double-blind, controlled study, we investigated the effect of adding IT magnesium sulphate to bupivacaine-fentanyl spinal anaesthesia. ⋯ In patients undergoing lower extremity surgery, the addition of IT magnesium sulphate (50 mg) to spinal anaesthesia induced by bupivacaine and fentanyl significantly delayed the onset of both sensory and motor blockade, but also prolonged the period of anaesthesia without additional side-effects.
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Acta Anaesthesiol Scand · Nov 2005
Case ReportsDextrose 5% in water: fluid medium for maintaining electrical stimulation of peripheral nerves during stimulating catheter placement.
It is well documented that a higher electrical current is required to elicit a motor response following a normal saline (NS) injection during the placement of stimulating catheters for peripheral nerve block. We present three cases of continuous brachial plexus catheter placement in which Dextrose 5% in water (D5W) was used to dilate the perineural space instead of NS. Three brachial plexus blocks (two interscalene and one axillary) were performed in three different patients for pain relief. ⋯ A corresponding motor response was maintained when the current applied to the stimulating catheter was less than 0.5 mA. Local anesthetic was then injected and the motor response immediately ceased. All blocks were successful and provided excellent pain relief with the continuous infusion of local anesthetics.
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Acta Anaesthesiol Scand · Nov 2005
Randomized Controlled TrialInfluence of orientations of guidewire tip on the placement of subclavian venous catheters.
The role of a J-type guidewire tip has been known to prevent vascular or cardiac wall damage. We hypothesized that the course of the guidewire may be influenced by the initial orientations of the J-type guidewire tip during the subclavian approach. The purpose of this study was to investigate the influence of the direction of the needle bevel and J-wire tip on successful placement of subclavian catheters. ⋯ These data suggest that the orientation of the J-wire tip downward can increase successful placement rates of right subclavian venous catheterization.
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Acta Anaesthesiol Scand · Nov 2005
Effect of pulmonary artery pressure on extravascular lung water in an experimental model of acute lung injury.
Lung edema can be influenced by hemodynamic changes in pulmonary circulation. The aim of this study was to evaluate, in an experimental model of acute lung injury, the effect on extravascular lung water (EVLW) of an increase in pulmonary artery pressure (Ppa) without changes in cardiac output and wedge pressure. ⋯ In this model, an increase in pulmonary artery pressure by alveolar hypoxia produces an increase in extravascular lung water, probably related to changes in pulmonary capillary pressures.