Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2010
Impact of the CYP2D6 genotype on post-operative intravenous oxycodone analgesia.
Oxycodone is a semi-synthetic opioid with a mu-receptor agonist-mediated effect in several pain conditions, including post-operative pain. Oxycodone is metabolized to its active metabolite oxymorphone by O-demethylation via the polymorphic CYP2D6. The aim of this study was to investigate whether CYP2D6 poor metabolizers (PMs) yield the same analgesia post-operatively from intravenous oxycodone as extensive metabolizers (EMs). ⋯ This study showed for the first time in patients that the oxymorphone formation depends on CYP2D6, but we found no difference in the post-operative analgesic effect of intravenous oxycodone between the two CYP2D6 genotypes.
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Acta Anaesthesiol Scand · Feb 2010
Comparative StudyComparison of desaturation and resaturation response times between transmission and reflectance pulse oximeters.
In general, there is a response time between actual arterial hypoxemia and its detection by pulse oximeters. We compared the desaturation and resaturation response times between two types of pulse oximeters, transmission and reflectance pulse oximeters, to find out which oximeter has a more rapid response time. ⋯ In clinical situations in which rapid changes in oxygen saturation are expected, we recommend the forehead reflectance pulse oximeter because it responds more quickly in detecting oxygen desaturation and resaturation compared with the transmission pulse oximeter.
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Acta Anaesthesiol Scand · Feb 2010
Comparative StudyShould dynamic parameters for prediction of fluid responsiveness be indexed to the tidal volume?
The respiratory variation in the pre-ejection period (Delta PEP) has been used to predict fluid responsiveness in mechanically ventilated patients. Recently, we modified this parameter (PEPV) and showed that it was a reliable predictor for post-cardiac surgery, mainly paced, patients when moderately low tidal volumes were used. One of the modifications involved tidal volume indexation, which had not been proposed before for dynamic parameters. The aim of the present animal study was to investigate whether indexation to tidal volume should be part of a new definition of dynamic parameters such as the case for our newly proposed PEPV. ⋯ Our study indicates that dynamic parameters are improved by indexing to tidal volume.
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Acta Anaesthesiol Scand · Feb 2010
Randomized Controlled Trial Comparative StudyEndotracheal tube size and sore throat following surgery: a randomized-controlled study.
Women experience less frequent and less severe sore throat postoperatively after intubation with a size 6.0 ETT versus size 7.0.
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Acta Anaesthesiol Scand · Feb 2010
Implementing a pre-operative checklist to increase patient safety: a 1-year follow-up of personnel attitudes.
The operating room is a complex work environment with a high potential for adverse events. Protocols for perioperative verification processes have increasingly been recommended by professional organizations during the last few years. We assessed personnel attitudes to a pre-operative checklist ('time out') immediately before start of the operative procedure. ⋯ Staff attitudes toward a surgical checklist were mostly positive 1 year after their introduction in two large hospitals in central Sweden.