Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2005
Randomized Controlled Trial Clinical TrialInfluence of the injection site (L2/3 or L3/4) and the posture of the vertebral column on selective spinal anesthesia for ambulatory knee arthroscopy.
We tested the hypothesis that selective spinal anesthesia for ambulatory knee arthroscopy can be accomplished with a small dose of bupivacaine at the L3/4 interspace with or without a head-down tilt of 5 degrees when the patients were in the lateral decubitus position. ⋯ When producing selective spinal anesthesia, the posture of the vertebral column is a major determinant of both sensory and motor segments to be blocked. A 4-mg dose of hyperbaric bupivacaine at the L3/4 interspace with a 5 degrees head-down tilt of the vertebral column for 6 min is recommended for knee arthroscopy.
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Acta Anaesthesiol Scand · Jan 2005
Improved resuscitation outcome in emergency medical systems with increased usage of sodium bicarbonate during cardiopulmonary resuscitation.
The use of sodium bicarbonate (SB) in cardiopulmonary resuscitation (CPR) is controversial. This study analyzes the effects of SB use on CPR outcome in the Brain Resuscitation Clinical Trial III (BRCT III), which was a multicenter randomized trial comparing high-dose to standard-dose epinephrine during CPR. Sodium bicarbonate use in BRCT III was optional. ⋯ Earlier and more frequent use of SB was associated with higher early resuscitability rates and with better long-term outcome. Sodium bicarbonate may be beneficial during CPR, and it should be subjected to a randomized clinical trial.
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Acta Anaesthesiol Scand · Jan 2005
Case ReportsUnilateral bronchospasm following interpleural analgesia with bupivacaine.
The interpleural block (IPB) is a relatively safe procedure and is commonly practised to provide analgesia. A local anaesthetic injected into the interpleural space spreads widely to block various neural structures. ⋯ In addition, unilateral reduction of intercostal muscle tone with consequential selective reduction of the functional residual capacity of that lung may also mimic airflow obstruction. We report a case of unilateral bronchospasm encountered following IPB.
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Acta Anaesthesiol Scand · Jan 2005
Case ReportsIsolated bilateral paralysis of the hypoglossal and recurrent laryngeal nerves (Bilateral Tapia's syndrome) after transoral intubation for general anesthesia.
Tapia's syndrome is due to extracranial involvement of the hypoglossal nerve and the recurrent laryngeal branch of the vagal nerve. The injury of these nerves is a rare complication of anesthetic airway management. ⋯ Forty-eight hours later, the movements of the vocal cords started to recover and full recovery was achieved by the fourth day. Within 3 days, tongue mobility was gradually improved and the patient's symptoms resolved completely by 4 weeks.
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Acta Anaesthesiol Scand · Jan 2005
Clinical TrialThe relationship between bispectral index and targeted propofol concentration is biphasic in patients with major burns.
Many pathophysiologic alterations in major burns can cause changes in the distribution of, and perhaps response to, drugs commonly used in anesthesia practice. This study was conducted to assess changes in bispectral index (BIS) caused by increasing the target propofol effect-site concentration during a target-controlled infusion (TCI) in major burns. ⋯ In major burns, the final biphasic BIS responses appeared to be determined by numerous other variables such as BIS algorithm, TCI performance, and altered propofol pharmacokinetics and pharmacodynamics. According to our results the importance of an individually tailored approach, including careful anesthetic titration, based upon the patient's clinical condition and responses can not be overemphasized.