Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 2005
Randomized Controlled Trial Clinical TrialEffects of ephedrine on intubating conditions following priming with rocuronium.
Onset of action of muscle relaxants is influenced by cardiac output and muscle blood flow. Ephedrine reduces the onset time of rocuronium. Onset is also shortened by priming. Accordingly, we hypothesized that priming combined with ephedrine is superior to either technique used separately. ⋯ Ephedrine in combination with propofol significantly improved clinical intubating conditions at 30 s following priming with rocuronium compared with priming with ephedrine without priming.
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Acta Anaesthesiol Scand · Jul 2005
Randomized Controlled Trial Clinical TrialEffect of low-dose N-acetyl-cysteine infusion on tourniquet-induced ischaemia-reperfusion injury in arthroscopic knee surgery.
Temporary occlusion of blood flow is used during arthroscopic knee surgery in order to provide a bloodless surgical field. The resulting ischaemia-reperfusion causes lipid peroxidation, which contributes to tissue injury. The aim of the study was to investigate the effect of low-dose n-acetyl cysteine (NAC) infusion on oxidative stress by determining malondialdehyde (MDA) levels during arthroscopic knee surgery. ⋯ Low-dose n-acetyl cysteine infusion attenuates lipid peroxidation and ischaemia-reperfusion injury in arthroscopic knee surgery requiring tourniquet application.
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Acta Anaesthesiol Scand · Jul 2005
ReviewAftermath of an adverse event: supporting health care professionals to meet patient expectations through open disclosure.
An important element of how adverse events are handled is effective communication between health care providers and patients and their families. This review addresses the main questions: What do patients expect in the aftermath of an adverse event? What is known about the practice of open disclosure? How can organizations support health care providers in the aftermath of an adverse event, both professionally and personally? Patients clearly expect open disclosure to include an explanation of what happened, an apology for harm done, that appropriate remedial action will be taken and an explanation of what will be done to learn from the event and to prevent recurrence. Research has found that open disclosure is not very common although the ethical duty to disclose is widely acknowledged. ⋯ Significant commitment is required from health care organizations and managers to develop frameworks for open disclosure to occur, to assure its quality and to support health care providers in this process. Organizations also need to address the emotional needs of health care professionals in the aftermath of an adverse event. Last but not least, adequate systems for debriefing and incident analysis need to be in place to learn from adverse events and to avoid recurrence.
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Acta Anaesthesiol Scand · Jul 2005
Randomized Controlled Trial Comparative Study Clinical TrialEffects of sevoflurane and desflurane on cytokine response during tympanoplasty surgery.
This study was devised to compare the effects of sevoflurane and desflurane anaesthesia on the cytokine response. ⋯ Desflurane appears to cause a greater systemic and intrapulmonary pro-inflammatory response than sevoflurane during anaesthesia for ear surgery.
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Acta Anaesthesiol Scand · Jul 2005
Randomized Controlled Trial Clinical TrialXenon anaesthesia may preserve cardiovascular function in patients with heart failure.
The hypothesis that xenon anaesthesia provided haemodynamic stability was tested in patients with heart failure in a prospective, randomized, single-blind design. ⋯ With propofol, MAP is reduced and LVEF is not increased in spite of reduced afterload. In contrast, MAP and LVEF are maintained with xenon.