Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2005
Randomized Controlled Trial Comparative Study Clinical TrialCerebral blood flow velocity increases when propofol is changed to desflurane, but not when isoflurane is changed to desflurane in children.
Children may exhibit delayed emergence following maintenance of anesthesia with propofol or isoflurane. Desflurane is often used towards the end of procedures to facilitate emergence. This study evaluated the effect on middle cerebral artery blood flow velocity (Vmca) in anesthetized children when propofol or isoflurane was substituted with desflurane. ⋯ When propofol is changed to desflurane, cerebral blood flow velocity increases significantly in normal children. This cerebral vasodilatory effect may have important implications in the neurosurgical setting.
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Acta Anaesthesiol Scand · Jan 2005
Randomized Controlled Trial Clinical TrialPentoxifylline attenuates the increase in whole blood viscosity after transfusion.
Pentoxifylline improves tissue oxygenation and intestinal blood flow in models of haemorrhagic shock, and it has been used for the treatment of intermittent claudication due to its beneficial effects on haemorheology. We investigated the effects of pentoxifylline on whole blood viscosity during packed red-blood cell transfusion in critically ill adult patients. ⋯ These results suggest that pentoxifylline is effective in attenuating the increase in whole blood viscosity after a transfusion of packed red-blood cells. Plasma viscosity is not influenced by pentoxifylline.
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Acta Anaesthesiol Scand · Jan 2005
Case ReportsSedation and fiberoptic intubation of a neonate with a cystic hygroma.
The flexible bronchoscope (FB) has been used to secure the difficult airway in pediatric patients. Difficult intubations in patients with cystic hygromas have been performed in awake patients or after the induction of general anesthesia. A recent case report acknowledges the challenges of performing intubations in pediatric patients under sedation because of their inability to fully cooperate. The following case demonstrates the two step-two fiberoptic bronchoscopic tracheal intubation performed using sedation and topical anesthesia in a neonate with a difficult airway.
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Acta Anaesthesiol Scand · Jan 2005
Motor nerve blockade potency and toxicity of non-racemic bupivacaine in rats.
Racemic [RS(+/-)] bupivacaine can be associated with severe cardiotoxicity. The S(-) isomer is known to be less neuro- and cardiotoxic, but demonstrates a lower potency to block motor activity than RS(+/-) bupivacaine. Thus, the potency and toxicity of a non-racemic bupivacaine mixture were studied. ⋯ The potency of S(-) bupivacaine to block the motor activity in the sciatic nerve was enhanced when 25% of the S(-) isomer was replaced by the antipode R(+) bupivacaine. This effect was not associated with increased toxicity.