Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2013
Cerebral energy metabolism during induced mitochondrial dysfunction.
In patients with traumatic brain injury as well as stroke, impaired cerebral oxidative energy metabolism may be an important factor contributing to the ultimate degree of tissue damage. We hypothesize that mitochondrial dysfunction can be diagnosed bedside by comparing the simultaneous changes in brain tissue oxygen tension (PbtO(2)) and cerebral cytoplasmatic redox state. The study describes cerebral energy metabolism during mitochondrial dysfunction induced by sevoflurane in piglets. ⋯ Intracerebral microdialysis revealed mitochondrial dysfunction by marked increases in cerebral lactate and lactate/pyruvate ratio simultaneously with normal levels of pyruvate and a normal PbtO(2). This metabolic pattern is distinctively different from cerebral ischemia, which is characterized by simultaneous decreases in PbtO(2) and intracerebral pyruvate.
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Acta Anaesthesiol Scand · Feb 2013
Randomized Controlled TrialDosage finding for low-dose spinal anaesthesia using hyperbaric prilocaine in patients undergoing perianal outpatient surgery.
Hyperbaric prilocaine 20 mg/ml may be preferable for perianal outpatient surgery. The aim of this prospective, single-centre, randomised, single-blinded, controlled clinical trial was to determine the optimal dosage of hyperbaric prilocaine 20 mg/ml for a spinal anaesthesia (SPA) in patients undergoing perianal outpatient surgery. ⋯ Hyperbaric prilocaine 20 mg/ml can be applied in dosages of 10, 20 and 30 mg for SPA in perianal surgery. Because of sufficient analgesia, missing motor block and shorter recovery times, 10 mg of hyperbaric prilocaine 20 mg/ml can be recommended for perianal outpatient surgery.
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Acta Anaesthesiol Scand · Feb 2013
Clinical impact of the publication of S3 guidelines for intensive care in cardiac surgery patients in Germany: results from a postal survey.
The development and implementation of practice guidelines might be an important tool to evaluate the different practices and to consider different local strategies. ⋯ Despite ongoing variability in the use of monitoring devices, volume replacement and vasopressor/inotrope use in cardiac surgery patients, there have been some changes in the therapy of these patients after publication of the guidelines. Because the guideline has been considered as clinically relevant, further interdisciplinary development and implementation support should be considered.