Acta anaesthesiologica Scandinavica
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In order to reduce comsumption of inhalational anaesthetsics during high-flow anaesthesia, a system open in regard to oxygen, nitrogen and nitrous oxide, but closed to inhalational anaesthetics, was developed. This was achieved by a reflecting filter for inhalational anaesthetics made of active carbon. ⋯ The ACD can be used for administering the inhalational agents isoflurane and sevoflurane as an alternative to low-flow anaesthesia systems during surgery. It can also be used in intensive care units to administer sedation using isoflurane or sevoflurane to critically ill patients.
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Acta Anaesthesiol Scand · Oct 2013
Multicenter Study Comparative Study Observational StudyReversal of rocuronium induced neuromuscular block with sugammadex or neostigmine: a large observational study.
This 'real-life' study aimed to analyze the time from the start of neostigmine or sugammadex administration to recovery to a train of four ratio (TOFr) of 0.9 in a real-life in patients receiving rocuronium. The secondary aims were to assess the proportion of patients: presenting TOFr < 0.9 after 5, 10, and 20 min from reversal agent administration, receiving opioids for intraoperative analgesia and extubated in the post-anesthesia care unit (PACU). ⋯ This real-life study confirms that reversal time is faster in patients receiving sugammadex than in those receiving neostigmine. TOFr < 0.9 20 min after reversal was only present in patients treated with neostigmine.
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Acta Anaesthesiol Scand · Oct 2013
Improving operating room first start efficiency - value of both checklist and a pre-operative facilitator.
There are multiple components leading to improved operating room efficiency. We undertook a project focusing on first case starts; accounting for each delay component on a global basis. Our hypothesis was there would be a reduction in first start delays after we implemented strategies to address the issues identified through this accounting process. ⋯ While we have a challenging operating room environment based on our patient population, multiple trainees in both the surgery and anaesthesiology teams: an orange sheet - pre-operative checklist in addition to a dedicated pre-operative facilitator; allowed us to make a substantial improvement in our first start on time starts.
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Acta Anaesthesiol Scand · Oct 2013
Skin temperature measured by infrared thermography after ultrasound-guided blockade of the sciatic nerve.
In the present study, we assessed the relationship between subgluteal sciatic nerve blocking and skin temperature by infrared thermography in the lower extremity. We hypothesized that blocking the sciatic nerve will lead to an increase in temperature, and that this will correlate with existing sensory block tests. ⋯ After sciatic nerve block, temperatures of the foot increased significantly. There was a good correlation between pinprick testing and infrared temperature measurement. This makes infrared skin temperature measuring a good test in determining block success when sensory testing is impossible.
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Acta Anaesthesiol Scand · Oct 2013
Diastolic dysfunction of the left ventricle is associated with pulmonary edema after renal transplantation.
Post-operative pulmonary complications are associated with high mortality and graft loss in renal transplantation recipients. Left ventricular diastolic dysfunction is not uncommon in patients with chronic renal failure, including those with preserved left ventricular systolic function. The purpose of this study was to determine the relationship between left ventricular diastolic dysfunction and incidence of post-operative pulmonary edema in renal transplantation recipients with preserved left ventricular systolic function. ⋯ Pre-operative left ventricular diastolic dysfunction correlated with the development of post-operative pulmonary edema in renal transplantation recipients. Meticulous intraoperative volume therapy is important to avoid post-operative pulmonary edema in such patients.