Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Oct 2007
Randomized Controlled Trial Comparative StudyDetection of tracheal malpositioning of nasogastric tubes using endotracheal cuff pressure measurement.
Insertion of a gastric tube (GT) in anaesthetized, paralyzed and intubated patients may be difficult. Tracheobronchial malposition of a GT may result in deleterious consequences. The purpose of this study was to determine the reliability of tracheal cuff pressure measurement to detect endobronchial malposition of GTs. We compared this new method with the measurement of exhaled CO(2) through the GT. ⋯ In intubated patients, cuff pressure measurement during insertion of a gastric tube is a new, simple and reliable bedside method to detect endotracheal malpositioning of a GT.
-
Acta Anaesthesiol Scand · Oct 2007
Limitations of arterial pulse pressure variation and left ventricular stroke volume variation in estimating cardiac pre-load during open heart surgery.
In addition to their well-known ability to predict fluid responsiveness, functional pre-load parameters, such as the left ventricular stroke volume variation (SVV) and pulse pressure variation (PPV), have been proposed to allow real-time monitoring of cardiac pre-load. SVV and PPV result from complex heart-lung interactions during mechanical ventilation. It was hypothesized that, under open-chest conditions, when cyclic changes in pleural pressures during positive-pressure ventilation are less pronounced, functional pre-load indicators may be deceptive in the estimation of ventricular pre-load. ⋯ SVV and PPV may be misleading when estimating cardiac pre-load during open heart surgery.
-
Acta Anaesthesiol Scand · Oct 2007
Randomized Controlled Trial Comparative StudyMethylprednisolone and ketorolac rapidly reduce hyperalgesia around a skin burn injury and increase pressure pain thresholds.
Glucocorticoids and non-steroidal anti-inflammatory drugs (NSAIDs) decrease acute postoperative pain and hyperalgesia. The objectives of this study were to investigate the effects of methylprednisolone and ketorolac on hyperalgesia around a skin burn injury and on pressure pain thresholds. ⋯ Methylprednisolone and ketorolac increased PPTT attenuated secondary hyperalgesia around a skin burn injury. PPTT increased after both methylprednisolone and ketorolac. The present study demonstrates analgesic and anti-hyperalgesic properties of a glucocorticoid and a non-selective NSAID that have not been demonstrated previously in human subjects.
-
Acta Anaesthesiol Scand · Oct 2007
Randomized Controlled Trial Comparative StudyEffect of 3 g of intravenous paracetamol on post-operative analgesia, platelet function and liver enzymes in patients undergoing tonsillectomy under local anaesthesia.
Paracetamol is often given as an adjunctive analgesic to reduce opioid-related adverse effects but its optimal dose is unknown. We studied the analgesic effect and safety of a single 3-g intravenous (i.v.) dose of paracetamol in adults. ⋯ During the initial hours after tonsillectomy, the administration of 3 g of i.v. paracetamol and 75 mg of diclofenac reduced the consumption of morphine. Both drugs also reduced the release of thromboxane B(2) from activated platelets but only diclofenac had a negative effect on platelet aggregation. In sensitive individuals, large doses of paracetamol may disturb the hepatocellular integrity. We do not recommend the use of i.v. doses of paracetamol higher than 1 g.
-
Acta Anaesthesiol Scand · Oct 2007
Severe head injury: control of physiological variables, organ failure and complications in the intensive care unit.
In patients with severe head injury, control of physiological variables is important to avoid intracranial hypertension and secondary injury to the brain. The aims of this retrospective study were to evaluate deviations of physiological variables and the incidence of extracranial complications in patients with severe head injury. We also studied if these deviations could be related to outcome. ⋯ Deviations of key physiological variables and pulmonary complications were frequent in patients suffering from severe head injury. During intensive care treatment, hypotension, elevated blood sugar and hypoalbuminemia are possible independent predictors of an unfavourable outcome.