Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 2012
Randomized Controlled Trial Comparative StudyLocal infiltration analgesia with levobupivacaine compared with intrathecal morphine in total hip arthroplasty patients.
Recently, local infiltration analgesia (LIA) has been promoted for pain control after total hip arthroplasty (THA). We hypothesized that LIA would offer equal analgesic efficacy but less adverse effects, e.g., nausea and vomiting, when compared with an established regimen [intrathecal morphine (it-M)] after THA. ⋯ While LIA might enable earlier mobilization after THA, it was not associated with less nausea as compared with it-M. Less rescue oxycodone was given early after it-M, but urinary retention was more common in that group.
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Acta Anaesthesiol Scand · Jul 2012
Thiopental dose requirements for induction of anaesthesia and subsequent endotracheal intubation in patients with complete spinal cord injuries.
Dose requirements of thiopental depend on patient characteristics and infusion rate. We determined thiopental dose requirements for induction of anaesthesia, and the effects of remifentanil on cardiovascular and bispectral index (BIS) responses to tracheal intubation in spinal cord-injured (SCI) patients undergoing general anaesthesia. ⋯ These results suggest that the dose requirements of thiopental for induction of general anaesthesia and subsequent tracheal intubation are reduced in the SCI patients.
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Acta Anaesthesiol Scand · Jul 2012
Dynamic variables of fluid responsiveness during pneumoperitoneum and laparoscopic surgery.
Few data exist on dynamic variables predicting fluid responsiveness during laparoscopic surgery. The aim of this study was to explore the effects of laparoscopy on four dynamic variables: respiratory variations in pulse pressure (ΔPP), stroke volume variation by Vigileo/FloTrac (SVV (Vigileo) ), pleth variability index (PVI) and respiratory variations in pulse oximetry plethysmography waveform amplitude (ΔPOP), and their relation to fluid challenges during laparoscopic surgery. ⋯ ΔPP and SVV (Vigileo) did not change as pneumoperitoneum was established, whereas PVI increased and ΔPOP tended to increase. All four dynamic variables predicted fluid responsiveness relatively poor during ongoing laparoscopic surgery. ΔPP and SVV (Vigileo) tracked changes in stroke volume induced by fluid challenges during ongoing laparascopic surgery, whereas ΔPOP and PVI did not.
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Acta Anaesthesiol Scand · Jul 2012
Comparative StudyAgreement between cardiac outputs by four-dimensional echocardiography and thermodilution method is poor.
The objective of the study was to determine the agreement of cardiac output (CO) measured by four-dimensional echocardiography (4D echo) to simultaneously obtain CO from pulmonary artery catheter (PAC) using thermodilution technique. ⋯ The agreement between COs by 4D echo and standard PAC thermodilution technique was poor. 4D echo underestimates CO as compared with PAC. This is most likely caused by the analysis software or low frame rate inherent to the technique.