Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2009
Impact of a regional anesthesia rotation on ultrasonographic identification of anatomic structures by anesthesiology residents.
The specific aim of this study was to determine the ability of anesthesiology residents to independently identify a series of anatomic structures in a live model using ultrasound, both before and after a 4-week regional anesthesia rotation that incorporates a standardized ultrasound training curriculum for peripheral nerve blockade. ⋯ Ultrasound-naive anesthesiology residents, who received instruction and experience with ultrasound-guided peripheral nerve blocks on a 4-week regional anesthesia rotation, significantly improved their ability to independently identify relevant anatomic structures with ultrasonography.
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Acta Anaesthesiol Scand · Mar 2009
Randomized Controlled Trial Comparative StudyComparison of intrathecal magnesium, fentanyl, or placebo combined with bupivacaine 0.5% for parturients undergoing elective cesarean delivery.
Intrathecal (i.t.) administration of magnesium has been reported to potentiate opioid antinociception in rats and humans. In this prospective, randomized, double-blind, study, we investigated the sensory, motor, and analgesic block characteristics of i.t. magnesium 50 mg compared with fentanyl 25 microg and saline when added to 0.5% bupivacaine (10 mg). ⋯ In patients undergoing cesarean section with spinal anesthesia, the addition of magnesium sulfate (50 mg) i.t. to 10 mg of spinal bupivacaine (0.5%) did not shorten the onset time of sensory and motor blockade or prolong the duration of spinal anesthesia, as seen with fentanyl.
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Acta Anaesthesiol Scand · Mar 2009
Equal effects of gelatin and hydroxyethyl starch (6% HES 130/0.42) on modified thrombelastography in children.
Artificial colloids are frequently used to prevent or treat circulatory failure due to hypovolaemia. Whereas gelatin has been shown not to affect coagulation besides its haemodilutional effect, hydroxyethyl starches (HES) have additional negative effects on haemostasis. The third-generation HES solutions have been developed to minimise these effects. We therefore conducted a prospective, randomised study, to verify the hypothesis that a 6% HES 130/0.42/6 : 1 and a 4% gelatin infusion influences modified thrombelastography (TEM) parameters in children in the same manner and to the same extent. ⋯ In conclusion, we could demonstrate that the investigational product, HES 130/0.42/6 : 1 solution, administered at a dosage of 10 ml/kg to children, had comparable effects on coagulation monitored with TEM as a gelatin solution. Perioperative administration of HES 130/0.42/6 : 1 does not alter coagulation to an extent above and beyond the effect of haemodilution.
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Acta Anaesthesiol Scand · Mar 2009
Randomized Controlled TrialDepth of anaesthesia monitoring in obese patients: a randomized study of propofol-remifentanil.
In obese patients, depth of anaesthesia monitoring could be useful in titrating intravenous anaesthetics. We hypothesized that depth of anaesthesia monitoring would reduce recovery time and use of anaesthetics in obese patients receiving propofol and remifentanil. ⋯ No significant reduction in time to eye opening could be demonstrated when a CSM was used to titrate propofol and remifentanil in obese patients undergoing a hysterectomy. A significant reduction in remifentanil consumption was found.
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Acta Anaesthesiol Scand · Mar 2009
Clinical TrialProcedure-related pain among adult patients with hematologic malignancies.
Cancer patients undergo numerous invasive diagnostic procedures. However, there are only sparse data on the characteristics and determinants for procedure-related pain among adult cancer patients. ⋯ We found that 3/4 of hematologic patients who underwent BMA reported procedural pain; one third of these patients indicated severe pain. Pre-existing pain, anxiety about the diagnostic outcome of BMA or needle-insertion, and low employment status were independent risk factors.