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
Randomized Controlled Trial Comparative Study Observational StudyInfluence of face mask design on bag-valve-mask ventilation performance: a randomized simulation study.
Different face mask designs can influence bag-valve-mask (BVM) ventilation performance during resuscitation. We compared a single-use, air-cushioned face mask (AM) with a reusable silicone face mask (SM) for quality of BVM ventilation on a manikin simulating cardiac arrest. ⋯ The AM seems to be a more efficient face mask than the SM at delivering sufficient ventilation volumes. The performance of the AM did not seem to be associated with the physical characteristics of the rescuers, whereas that of the SM was affected by these factors. The SM may not be an appropriate face mask for performing one-person BVM ventilation during resuscitation for rescuers who are smaller in stature, have a smaller hand size, or have weaker grip power.
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Total hip and knee arthroplasty (THA and TKA) are frequently performed surgical procedures with excellent long-term functional outcomes. However, pain is pronounced in the early post-operative phase, especially after TKA. Glucocorticoids have proven to relieve post-operative pain, but a higher dose might be needed, as compared with the lower dose recommended to reduce post-operative nausea and vomiting (PONV). Prior to this PhD study, procedure-specific data were limited on the effects of high-dose glucocorticoid on post-operative pain and recovery in THA and TKA. So, the following question remained to be answered: does high-dose glucocorticoid added to a multimodal analgesic regime reduce pain and improve recovery after THA and TKA? ⋯ This PhD thesis render new knowledge by demonstrating - for the first time - detailed procedure-specific beneficial effects of a single pre-operative dose of MP, 125 mg IV, on acute post-operative analgesia in THA, and on acute post-operative analgesia and on other immediate recovery aspects in TKA. Noteworthy, these benefits were observed with MP added to a comprehensive multimodal oral analgesic regime consisting of paracetamol, celecoxib and gabapentin - and in TKA also to an intra-operative local infiltration analgesia regimen. However, current data in hip and knee surgery preclude firm safety conclusions, and call for large-scale studies to definitively clarify the risk-benefit ratio, before final recommendations can be made. Also, the shortage of dose-finding data calls for studies to define the minimal effective dose to provide post-operative analgesia.
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Acta Anaesthesiol Scand · Oct 2013
Randomized Controlled Trial Comparative StudyEpidural vs. intravenous fentanyl during colorectal surgery using a double-blind, double-dummy design.
Epidural fentanyl has direct neuraxial analgesic effects distinct from systemic analgesic effects.
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