Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2011
Case ReportsAnaphylaxis to ethylene oxide - a rare and overlooked phenomenon?
Spina bifida patients have been reported to be at increased risk of anaphylactic reactions during general anaesthesia. Following a reaction, latex is often incriminated as spina bifida patients are known to have an increased incidence of latex allergy. Ethylene oxide (EO) has recently been suggested to be an alternative cause, but in many cases reported in the literature, it seems that EO has not been considered as a cause. ⋯ In addition, we describe measures taken during preparation of a subsequent general anaesthesia to minimise exposure to EO. Spina bifida patients seem to be at increased risk of sensitisation against EO due to repeated exposure, but only limited literature is available. To ensure that EO is considered as a cause in these cases, we recommend that testing for latex and EO go hand in hand following an anaphylactic reaction in this high-risk population.
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Acta Anaesthesiol Scand · Nov 2011
Review Meta AnalysisUltrasonography in the management of the airway.
In this study, it is described how to use ultrasonography (US) for real-time imaging of the airway from the mouth, over pharynx, larynx, and trachea to the peripheral alveoli, and how to use this in airway management. US has several advantages for imaging of the airway - it is safe, quick, repeatable, portable, widely available, and it must be used dynamically for maximum benefit in airway management, in direct conjunction with the airway management, i.e. immediately before, during, and after airway interventions. ⋯ US can identify the croicothyroid membrane prior to management of a difficult airway, can confirm ventilation by observing lung sliding bilaterally and should be the first diagnostic approach when a pneumothorax is suspected intraoperatively or during initial trauma-evaluation. US can improve percutaneous dilatational tracheostomy by identifying the correct tracheal-ring interspace, avoiding blood vessels and determining the depth from the skin to the tracheal wall.
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Acta Anaesthesiol Scand · Nov 2011
Comparative StudyTemporal comparison of ultrasound vs. auscultation and capnography in verification of endotracheal tube placement.
This study compared the time consumption of bilateral lung ultrasound with auscultation and capnography for verifying endotracheal intubation. ⋯ Verification of endotracheal tube placement with ultrasound is as fast as auscultation alone and faster than the standard method of auscultation and capnography.
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Acta Anaesthesiol Scand · Nov 2011
Validation and usefulness of the Danish version of the Pain Medication Questionnaire in opioid-treated chronic pain patients.
Addiction is a feared complication of long-term opioid therapy for chronic pain patients. A screening tool to assess the potential risk of addiction may be helpful. ⋯ The PMQ may assist physicians in addiction risk assessment and stratification when treating chronic pain patients with opioids. PMQ is not a diagnostic tool and should only be used as an indicator for possible addiction problems.