Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2006
Meta AnalysisA qualitative systematic review of peri-operative dextromethorphan in post-operative pain.
The N-methyl-D-aspartate (NMDA) receptor antagonist, dextromethorphan (DM), has received interest as an adjunctive agent in post-operative pain management. Clinical trials have been contradictory. This systematic review aims to evaluate the available literature examining the analgesic efficacy of DM in post-operative patients. ⋯ Based on the studies available, DM has the potential to be a safe adjunctive agent to opioid analgesia in post-operative pain management, but the consistency of the potential opioid-sparing and pain-reducing effect must be questioned. Consequently, it is not possible to recommend dose regimens or routine clinical use of DM in post-operative pain. The route of administration may be important for the beneficial effect.
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Acta Anaesthesiol Scand · Jan 2006
Randomized Controlled TrialEffects of intravascular volume therapy using hydroxyethyl starch (130/0.4) on post-operative bleeding and transfusion requirements in children undergoing cardiac surgery: a randomized clinical trial.
Hydroxyethyl starch (HES) used for intravascular volume expansion may cause coagulation abnormalities, especially in cardiac patients. Although low molecular weight HES (130/0.4) has been developed to minimize its influence on coagulation, experience with HES (130/0.4) in children is limited. Therefore, we evaluated the effects of a HES (130/0.4) infusion on post-operative blood loss in children undergoing cardiac surgery. ⋯ Our study shows that the administration of a moderate dose of HES (130/0.4) in children undergoing cardiac surgery does not cause more bleeding or a higher transfusion requirement than a FFP infusion, and suggests that the administration of 10 ml/kg HES (130/0.4) is a safe alternative to plasma for intravascular volume replacement in this patient population.
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Acta Anaesthesiol Scand · Jan 2006
Case ReportsA case of suspected non-neurosurgical adult fatal propofol infusion syndrome.
A previously healthy woman (20 years old) was admitted to our hospital with several fractures after a car accident. She was sedated with propofol, etc. in doses ranging from 1.4 to 5.1 mg/kg/h for 88 h. She developed multiple organ failure with rhabdomyolysis and died. This case fulfils (except acidosis) the criteria of propofol-infusion syndrome (PRIS) in a young adult.
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Acta Anaesthesiol Scand · Jan 2006
An interchangeable Mapleson A-E breathing system is practical and cost effective.
In locations where oxygen and anesthesia gas supplies are limited, and where circle systems are not practical, means to reduce fresh gas flow during maintenance of inhalational anesthesia are of potential value. We investigated whether a common transport breathing apparatus could be modified to allow interchange between Mapleson D (Map-D) and Mapleson A (Map A) configurations. ⋯ Cost and resource savings can be realized through the use of a breathing system modification that achieves appropriate ventilation at lower fresh gas flows.
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Acta Anaesthesiol Scand · Jan 2006
Randomized Controlled TrialSupplemental 80% oxygen does not attenuate post-operative nausea and vomiting after breast surgery.
Although supplemental oxygen has been shown to be as effective as ondansetron in the prevention of post-operative nausea and vomiting (PONV) in one study in abdominal surgery patients, the antiemetic efficacy of supplemental oxygen is controversial on the basis of studies with other patients. We compared the efficacy of 80% and 30% oxygen in decreasing PONV in breast surgery. Ondansetron was used as an active control. ⋯ In this study, supplemental 80% oxygen administration failed to decrease PONV in breast surgery.