Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2012
Review Meta AnalysisVasopressors for the management of hypotension after spinal anesthesia for elective caesarean section. Systematic review and cumulative meta-analysis.
Phenylephrine use has been recommended over ephedrine for the management of hypotension after spinal anesthesia for elective caesarean section. The evidence for this is rather limited because in previous trials, pH was significantly lower after ephedrine, but absolute values were still within normal range. We pooled the available data to define maternal and neonatal effects of the two vasopressors. ⋯ Our analysis could clearly demonstrate a decreased risk of fetal acidosis associated with phenylephrine use. In addition with our findings for BE, this suggests a favorable effect of phenylephrine on fetal outcome parameters. The mechanism of pH depression is not related to pCO(2) .
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Acta Anaesthesiol Scand · Aug 2012
Clinical TrialA newly developed scavenging system for administration of nitrous oxide during labour: safe occupational use.
Nitrous oxide (N(2) O) is routinely used as an analgesic in obstetrics during labour. Epidemiological studies have linked chronic occupational exposure to N(2) O to specific health problems, including reproductive risks. Occupational exposure limits (OELs) allow the use of N(2) O once appropriate preventive and safety measures have been taken. We assessed the effectiveness of a scavenger system (Anevac P-system®, Medicvent Heinen & Löwestein Benelux, Barneveld, the Netherlands) applied in N(2) O administration during labour in a midwifery-led birthing centre in the Netherlands. ⋯ The Anevac P-scavenging system during N(2) O analgesia in labour prevents exceeding OELs in professional workers. The scavenging system appeared acceptable and effective, and can be considered in hospital settings that use N(2) O as analgesic during labour.
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Acta Anaesthesiol Scand · Aug 2012
Randomized Controlled Trial Comparative StudyRelationship between positive end-expiratory pressure and internal jugular vein cross-sectional area.
Application of positive end-expiratory pressure (PEEP) has been used to increase the cross-sectional area (CSA) of the right internal jugular vein (IJV) in order to facilitate catheterisation. We aimed to determine the PEEP level at which the maximum increase of CSA occurred. ⋯ The application of PEEP effectively increases the CSA of the right IJV. The PEEP giving the largest CSA is 12 cm H(2) O.
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Acta Anaesthesiol Scand · Aug 2012
Randomized Controlled Trial Comparative StudyNon-steroidal anti-inflammatory drugs reduce the stress response during sevoflurane anesthesia.
Non-steroidal anti-inflammatory drugs are analgesics commonly used for post-operative pain. However, their effect on dosages of inhaled anesthetics during surgery is unclear. We investigated the effect of flurbiprofen axetil and parecoxib sodium on the minimum alveolar concentration of sevoflurane required to blunt stress responses to skin incision under general anesthesia. ⋯ The non-steroidal anti-inflammatory drugs flurbiprofen axetil and parecoxib sodium decreased the minimum alveolar concentration of sevoflurane required to blunt the stress response to skin incision during general anesthesia.