Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2009
Controlled Clinical TrialThe use of desflurane or propofol in combination with remifentanil in myasthenic patients undergoing a video-assisted thoracoscopic-extended thymectomy.
Although several studies of the use of desflurane in anesthesia have revealed many desirable qualities, there are no data on the use and effects especially on the neuromuscular function of desflurane on myasthenia gravis (MG) patients. The purpose of this study was to evaluate the use of either desflurane or propofol, both combined with remifentanil, in patients with MG undergoing a video-assisted thoracoscopic-extended thymectomy (VATET). ⋯ Our experience indicates that anesthesia with desflurane plus remifentanil in patients with MG could determine a reversible muscle relaxation effect, but with no clinical implication, allowing a faster recovery with no difference in extubation time and post-operative complications in the two groups.
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Acta Anaesthesiol Scand · Mar 2009
Case ReportsIntracerebral monitoring in comatose patients treated with hypothermia after a cardiac arrest.
Induced mild hypothermia (32-34 degrees C) has proven to reduce ischemic brain injury and improve outcome after a cardiac arrest (CA). The aim of this investigation was to study the occurrence of increased intracranial pressure (ICP) and neurochemical metabolic changes indicating cerebral ischemia, after CA and cardiopulmonary resuscitation (CPR), when induced hypothermia was applied. ⋯ Intracerebral microdialysis and ICP monitoring may be used in selected patients not requiring anticoagulants and PCI to obtain information regarding the common disturbances of intracranial dynamics after CA. The results of this study underline the importance of inducing hypothermia quickly after CA and emphasize the need for developing tools for guidance of the re-warming.
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Acta Anaesthesiol Scand · Mar 2009
Clinical TrialThe I-gel, a single-use supraglottic airway device with a non-inflatable cuff and an esophageal vent: an observational study in children.
The I-gel is a new single-use supraglottic airway device with a non-inflatable cuff. It is composed of a thermoplastic elastomer and a soft gel-like cuff that adapts to the hypopharyngeal anatomy. Like the LMA-ProSeal, it has an airway tube and a gastric drain tube. Little is known about its efficiency in pediatric anesthesia. ⋯ Because the I-gel has a very good insertion success rate and very few complications, it seems to be an efficient and safe device for pediatric airway management.