Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2010
Randomized Controlled Trial Comparative StudyProcedural pain of an ultrasound-guided brachial plexus block: a comparison of axillary and infraclavicular approaches.
Ultrasound (US)-guided infraclavicular (IC) and axillary (AX) blocks have similar effectiveness. Therefore, limiting procedural pain may help to choose a standard approach. The primary aims of this randomized study were to assess patient's pain during the block and to recognize its cause. ⋯ We did not find significant differences between the two approaches in procedural pain and patient's acceptance. The choice of approach may depend on the anaesthesiologist's experience and the patient's preferences.
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Acta Anaesthesiol Scand · Apr 2010
Randomized Controlled Trial Comparative StudyIs nerve stimulation needed during an ultrasound-guided lateral sagittal infraclavicular block?
The objective of the study was to evaluate the influence of ultrasound (US) guidance alone vs. neurostimulation (NS) and US (NSUS) guidance techniques on block performance time and block success rate for the lateral sagittal infraclavicular block (LSIB). ⋯ During LSIB performance US guidance alone produces block success rate identical to both US and NS guidance yet with a shorter block performance time.
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Acta Anaesthesiol Scand · Apr 2010
Impact of the post-World War II generation on intensive care needs in Norway.
A high birth rate during the first two decades following World War II has increased the proportion of elderly people in present-day society and, consequently, the demand for health-care services. The impact on intensive care services may become dramatic because the age distribution of critically ill patients is skewed towards the elderly. We have used registry data and population statistics to forecast the demand for intensive care services in Norway up until the year 2025. ⋯ The demand for intensive care beds will increase markedly in Norwegian hospitals in the near future. This will have serious implications for the planning of infrastructure, education of health care personnel, as well as financing of our health care system.
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Acta Anaesthesiol Scand · Apr 2010
Randomized Controlled TrialPredictive ability of propofol effect-site concentrations during fast and slow infusion rates.
The performance of propofol effect-site pharmacokinetic models during target-controlled infusion (TCI) might be affected by propofol administration rate. This study compares the predictive ability of three effect-site pharmacokinetic models during fast and slow infusion rates, utilizing the cerebral state index (CSI) as a monitor of consciousness. ⋯ Speed of infusion, within the ranges allowed by TCI pumps, significantly affects the accuracy of Ce predictions. The CSI monitor was shown to be a useful tool to predict LOC in both rapid and slow infusion schemes.
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Acta Anaesthesiol Scand · Apr 2010
Functional intravascular volume deficit in patients before surgery.
Stroke volume (SV) maximization with a colloid infusion, referred to as individualized goal-directed therapy, improves outcome in high-risk surgery. The fraction of patients who need intravascular volume to establish a maximal SV has, however, not been evaluated, and there are only limited data on the volume required to establish a maximal SV before the start of surgery. Therefore, we estimated the occurrence and size of the potential functional intravascular volume deficit in surgical patients. ⋯ The majority of anaesthetized patients present with a functional intravascular volume deficit before surgery. Although the deficit in general was minor, a fraction of patients presented with a deficit that may be of clinical relevance, emphasizing the importance of the individual approach of goal-directed fluid therapy.