Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2015
Review Meta AnalysisThe efficacy of propofol on emergence agitation - a meta-analysis of randomized controlled trials.
Emergence agitation (EA) is a common, post-anesthetic complication in pediatric patients following sevoflurane and desflurane anesthesia. The aim of this meta-analysis was to assess the effects of an adjunctive dose of propofol to reduce the incidence of EA in pediatric patients. ⋯ Future studies on the benefits of adjunct propofol in reducing the incidence of EA are required.
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Acta Anaesthesiol Scand · Nov 2015
ReviewMicrocirculatory dysfunction and tissue oxygenation in critical illness.
Severe sepsis is defined by organ failure, often of the kidneys, heart, and brain. It has been proposed that inadequate delivery of oxygen, or insufficient extraction of oxygen in tissue, may explain organ failure. Despite adequate maintenance of systemic oxygen delivery in septic patients, their morbidity and mortality remain high. ⋯ We review how capillary flow patterns affect oxygen extraction efficacy in tissue, and how the regulation of tissue blood flow must be adjusted to meet the metabolic needs of the tissue as capillary flows become disturbed as observed in critical illness. Using the brain, heart, and kidney as examples, we discuss whether disturbed capillary flow patterns might explain the apparent mismatch between organ blood flow and organ function in sepsis. Finally, we discuss diagnostic means of detecting capillary flow disturbance in animal models and in critically ill patients, and address therapeutic strategies that might improve tissue oxygenation by modifying capillary flow patterns.
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Acta Anaesthesiol Scand · Nov 2015
Randomized Controlled TrialIntra- and postoperative low-dose ketamine for adolescent idiopathic scoliosis surgery: a randomized controlled trial.
In this randomized controlled trial, we examined whether intra- and postoperative infusion of low-dose ketamine decreased postoperative morphine requirement and morphine-related adverse effects as nausea and vomiting after scoliosis surgery. ⋯ Intra- and postoperative infusion of low-dose ketamine reduced cumulative morphine consumption and antiemetic requirement for 48 h after surgery.
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Acta Anaesthesiol Scand · Nov 2015
Randomized Controlled TrialAlfentanil during rapid sequence induction with thiopental 4 mg/kg and rocuronium 0.6 mg/kg: tracheal intubation conditions.
Opioids have become an integral part of anaesthesia induction. We aimed to determine the dose of alfentanil needed to obtain perfect tracheal intubation conditions during rapid sequence induction with standard doses of thiopental and rocuronium, where laryngoscopy was initiated 55 s after commencement of drug administration. The influence of covariates (sex, body weight, age, alfentanil plasma concentration at laryngoscopy) was tested. ⋯ Perfect intubation conditions during rapid sequence induction can be obtained with clinically relevant doses of alfentanil in most healthy patients anaesthetized with thiopental 4 mg/kg and rocuronium 0.6 mg/kg.
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Acta Anaesthesiol Scand · Nov 2015
Pain-related psychological distress, self-rated health and significance of neuropathic pain in Danish soldiers injured in Afghanistan.
Pain and mental health concerns are prevalent among veterans. While the majority of research has focused on chronic pain as an entity, there has been little work directed towards investigating the role of neuropathic pain in relation to psychological comorbidity. As such, we hypothesised that participants with signs of neuropathic pain would report higher levels of psychological distress and diminished self-rated health compared to those without a neuropathic component. ⋯ The results from the present study suggest that neuropathic pain is related to increased psychological distress and deterioration in self-rated health in injured soldiers.