Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2008
Case ReportsBurst suppression during propofol anaesthesia recorded from scalp and subthalamic electrodes: report of three cases.
Measurement of slow EEG activity and burst suppression are the main tasks in monitoring the effects of anaesthestics with EEG, which is often done with commercial univariate indexes such as BIS. The aim of this study was to describe the characteristics of burst suppression EEG during propofol anaesthesia using scalp electrodes and depth electrodes in the subthalamic nucleus. Specifically, we describe the electrical fields of the three EEG patterns we have previously described: the sharp wave, the burst and the spindle. ⋯ Recording simultaneously EEG from the depth and scalp electrodes shows that bursts and their slow wave oscillations are synchronous in the whole cortex while spindles and sharp waves are produced by the sensorimotor cortex. The amplitude of slow waves recorded with surface electrodes is equal to the difference of the wave at two electrodes and therefore only a small part of that generated by the cortex.
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Acta Anaesthesiol Scand · Feb 2008
Case ReportsA case of unexpected difficult airway due to lingual tonsil hypertrophy.
Clinical value of preoperative bedside screening tests for predicting difficult airway remains limited. Asymptomatic lingual tonsil hypertrophy is a known cause of unexpected difficult airway. We report a case as a reminder of this.
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Acta Anaesthesiol Scand · Feb 2008
Randomized Controlled Trial Comparative StudyIntravenous remifentanil vs. epidural levobupivacaine with fentanyl for pain relief in early labour: a randomised, controlled, double-blinded study.
We hypothesised that intravenous patient-controlled analgesia (IV PCA) with remifentanil could provide as satisfactory pain relief for labour as epidural analgesia. ⋯ In terms of pain scores, epidural analgesia is superior to that provided by IV remifentanil. However, there was no difference in the pain relief scores between the treatments.
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Acta Anaesthesiol Scand · Feb 2008
Randomized Controlled Trial Clinical TrialDexmedetomidine blunts acute hyperdynamic responses to electroconvulsive therapy without altering seizure duration.
This study was designed to evaluate the effect of dexmedetomidine on the acute hyperdynamic response, duration of seizure activity and recovery times in patients undergoing electroconvulsive therapy (ECT). ⋯ A dexmedetomidine dose of 1 mug/kg IV administered over 10 min before the induction of anaesthesia with propofol may be useful in preventing the acute hyperdynamic responses to ECT without altering the duration of seizure activity and recovery time.
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Acta Anaesthesiol Scand · Feb 2008
Comparative Study Clinical TrialApplicability of tools to assess pain in elderly patients after cardiac surgery.
Post-operatively, elderly patients with impaired vision and cognitive dysfunction may experience difficulties understanding standard pain assessment tools such as the 10-cm Visual Analogue Scale (VAS) and the Verbal Rating Scale (VRS). Thus, there is a need to identify more feasible post-operative pain assessments for elderly patients. With this goal in mind, we compared the VAS and VRS with two more expressive tools: the 50-cm Red Wedge Scale (RWS) and the Facial Pain Scale (FPS). ⋯ In elderly patients, immediately after cardiac surgery, the VRS is the most feasible pain scale, followed by the RWS. The traditional 10-cm VAS is unsuitable for pain measurement in this population.