Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Sep 2005
Effect of prolonged mechanical ventilation on diaphragm muscle mitochondria in piglets.
Respiratory muscle weakness is a common problem in the intensive care unit and could be involved in difficulties in weaning from the ventilator after prolonged mechanical ventilation. Animal models have shown that mechanical ventilation itself impairs diaphragm muscle function. In this study we investigated whether diaphragm contractile impairment caused by mechanical ventilation and immobilization in piglets is associated with a derangement in diaphragm mitochondria. ⋯ Five days of mechanical ventilation and immobilization decreased the activity of complex IV of the mitochondrial respiratory chain in the diaphragm muscle of the piglets.
-
Acta Anaesthesiol Scand · Sep 2005
Randomized Controlled Trial Clinical TrialCombined general-epidural anesthesia decreases the desflurane requirement for equivalent A-line ARX index in colorectal surgery.
The present study used the A-line ARX index, derived from auditory evoked potential measurements, to examine the effect of epidural lidocaine on the end-tidal concentration of desflurane during general anesthesia. ⋯ Lower-than-expected concentrations of volatile anesthetics are sufficient to maintain appropriate a clinical anesthesia effect during combined general-epidural anesthesia under auditory-evoked potential monitoring.
-
Acta Anaesthesiol Scand · Sep 2005
Review Practice Guideline GuidelinePre-operative fasting guidelines: an update.
Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids are allowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for children and pregnant women not in labour. ⋯ What is still not clear is to what extent the new liberal fasting routines should apply to patients with functional dyspepsia or systematic diseases such as diabetes mellitus. Other still controversial areas include the need for and effect of fasting in emergency patients, women in labour and in association with procedures done under 'deep sedation'. We think more research on the effect of various fasting regimes in subpopulations of patients is needed before we can move one step further towards completely evidence-based pre-operative fasting guidelines.
-
Acta Anaesthesiol Scand · Sep 2005
Randomized Controlled Trial Clinical TrialNitrous oxide diffusion into tracheal tube cuffs--efficacy of a new prototype cuff pressure release valve.
The aim of this study was to evaluate the performance of a new cuff pressure release valve (CPRV), in which the release pressure can be adjusted from 10 to 25 cmH2O, particularly intended to control pressure in paediatric cuffed tracheal tubes and to avoid cuff hyperinflation caused by N2O diffusion. ⋯ The CPRV allows reliable cuff pressure release at various pressure levels and reliably prevents cuff pressure increases caused by N2O.
-
Acta Anaesthesiol Scand · Sep 2005
Review Case ReportsMcArdle's disease and anaesthesia: case reports. Review of potential problems and association with malignant hyperthermia.
McArdle's disease of isolated deficiency in glycogen degradation in skeletal muscles has the potential of creating perioperative anaesthesiological problems; such as hypoglycaemia, rhabdomyolysis, myoglobinuria, acute renal failure and possibly malignant hyperthermia. ⋯ McArdle's disease does not seem to cause severe perioperative problems in routine anaesthetic care. However, measures for preventing muscle ischaemia and rhabdomyolysis should be kept in mind, as well as the potential for these patients to develop postoperative fatigue, myoglobinuria and renal failure. Although no clinical association with malignant hyperthermia has been established, many of these patients can have a positive in vitro contracture test, and simple prophylactic measures, as with malignant hyperthermia, may be recommended if otherwise not contraindicated.