Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2005
Case ReportsThoracic epidural analgesia via the lumbar approach using nerve stimulation in a pediatric patient with Down syndrome.
This case illustrates the threading of an epidural catheter with electrical stimulation guidance from the lumbar epidural space to the thoracic space in a pediatric patient. A 17-year-old boy with Down syndrome, weighing 48 kg, was scheduled to undergo a laparotomy for duodenal obstruction and gastrostomy tube insertion. Combined general and continuous epidural anesthesia was selected for his anesthetic. ⋯ After 22 cm of the epidural catheter had been inserted, intercostal muscle movement (T9 - 10) was observed at 3.0 mA. Radiographical imaging later confirmed the catheter tip at T10. The patient awoke without distress and was discharged to the ward with subsequent good pain control from a continuous epidural infusion of bupivacaine 0.1% with 1 microg ml(-1) fentanyl at 4-6 ml(-1).
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Acta Anaesthesiol Scand · May 2005
Review Meta Analysis Comparative StudyEffect of preoperative Cox-II-selective NSAIDs (coxibs) on postoperative outcomes: a systematic review of randomized studies.
Preoperative use of coxibs has been claimed to reduce postoperative pain and analgesic consumption, and to affect other postoperative outcomes. ⋯ Preoperative coxibs had clear benefits in terms of reduced postoperative pain, analgesic consumption and patient satisfaction compared with placebo. Effects on postoperative nausea and vomiting remain uncertain, as do those on recovery from surgery or economic benefit. Future trials should be larger and more pragmatic in nature.
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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 Clinical TrialA-line autoregression index monitoring to titrate inhalational anaesthesia: effects on sevoflurane consumption, emergence time and memory.
A-line autoregression index (AAI) is a parameter derived from auditory evoked potentials proposed as depth of anaesthesia monitor. We evaluated the effects of AAI guidance on sevoflurane consumption, emergence time, explicit and implicit memory. ⋯ AAI titration of anaesthesia allows a significant reduction in sevoflurane consumption and emergence time without significant effects on the incidence of explicit and implicit memory. Nevertheless the relationship between AAI and memory requires studies in larger groups of patients.
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Acta Anaesthesiol Scand · May 2005
Comparative StudyPosterior labat vs. lateral popliteal sciatic block: posterior sciatic block has quicker onset and shorter duration of anaesthesia.
During foot and ankle surgery, a combination of a sciatic and femoral nerve block is a well-recognized technique for providing anaesthesia and post-operative analgesia. Our hypothesis is that the posterior gluteal sciatic block (PSB) is more efficient than the lateral popliteal sciatic block (LPSB), and this study compared the anaesthetic characteristics between these two techniques performed for elective ankle and foot surgery. ⋯ PSB is easier to perform, and has a quicker onset of sensory blockade whereas LPSB has a longer duration of analgesia.