Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2005
Comparative StudyComparison of a combination of midazolam and diazepam and midazolam alone as oral premedication on preanesthetic and emergence condition in children.
Preanesthetic anxiety and emergence agitation are major challenges for anesthesiologists in pediatric anesthesia. Thus, midazolam has been used as premedication for children. However, midazolam alone is not effective for emergence agitation. The present study tested the effect of a combination of midazolam and diazepam on the preanesthetic condition and emergence behavior in children. ⋯ Children in the Mi + Di group were significantly more sedated at induction of anesthesia and less agitated during emergence from anesthesia.
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Acta Anaesthesiol Scand · May 2005
Randomized Controlled Trial Clinical TrialIntentional lateral epidural catheter placement for anterior cruciate ligament reconstruction.
Unilateral epidural block might constitute a clinical option in lower limb orthopedic surgery. ⋯ These results suggest that the IUEC technique is a feasible and efficient method for providing anesthesia and analgesia for ACLR and is associated with a lower consume of anesthetics, less motor block and a reduced incidence of urinary retention.
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Acta Anaesthesiol Scand · May 2005
Randomized Controlled Trial Comparative Study Clinical TrialEfficacy of vertical infraclavicular plexus block vs. modified axillary plexus block: a prospective, randomized, observer-blinded study.
Despite containing severe risks, infraclavicular approaches to the brachial plexus gained increasing popularity. Likewise, the vertical infraclavicular plexus block improved anesthesia compared to the standard axillary approach but contains the risk of pneumothorax. Therefore we modified the standard axillary technique by inserting a proximal directed catheter, referred to as a high axillary plexus block. We prospectively compared quality and onset of neural blockade after vertical infraclavicular plexus block (VIP) and high axillary plexus block (HAP) in two randomized groups (30 patients in each). ⋯ While both techniques provide sufficient surgical anesthesia, vertical infraclavicular plexus block demonstrated a partially higher success rate and a faster onset than high axillary plexus block.
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Acta Anaesthesiol Scand · May 2005
Case ReportsAcute respiratory failure after deep cervical plexus block for carotid endarterectomy as a result of bilateral recurrent laryngeal nerve paralysis.
We report about a case of acute respiratory distress (73-year-old female), which occurred minutes after a deep cervical plexus block (40 ml ropivacaine 0.5%) for carotid endarterectomy (CEA) and required immediate endotracheal intubation of the patient's trachea and consecutive mechanical ventilation. Subsequently, CEA was performed under general anaesthesia (TIVA) with continuous monitoring by somatosensory-evoked potentials. After a period of 14 hours, the endotracheal tube could be removed, the patient being in fair respiratory, cardiocirculatory and neurological conditions. ⋯ Therefore, a thorough preoperative airway check is advisable in all patients scheduled for a cervical plexus block. Particularly in cases with a history of respiratory disorders or previous neck surgery a vocal cord examination is recommended, and the use of a superficial cervical plexus block may lower the risk of respiratory complications. This may prevent a possibly life-threatening coincidence of ipsilateral plexus blockade-induced and pre-existing asymptomatic contralateral RLN paralysis.
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Acta Anaesthesiol Scand · May 2005
Editorial Comparative StudyAlbumin has no benefit over saline in the critically ill.