Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2015
Transpulmonary pressure and lung elastance can be estimated by a PEEP-step manoeuvre.
Transpulmonary pressure is a key factor for protective ventilation. This requires measurements of oesophageal pressure that is rarely used clinically. A simple method may be found, if it could be shown that tidal and positive end-expiratory pressure (PEEP) inflation of the lungs with the same volume increases transpulmonary pressure equally. The aim of the present study was to compare tidal and PEEP inflation of the respiratory system. ⋯ PEEP inflation of the respiratory system is extremely slow, and allows the chest wall complex, especially the abdomen, to yield and adapt to intrusion of the diaphragm. As a consequence a change in transpulmonary pressure is equal to the change in PEEP and transpulmonary pressure can be determined without oesophageal pressure measurements.
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Acta Anaesthesiol Scand · Feb 2015
Meta AnalysisEfficacy and safety of pregabalin for treating painful diabetic peripheral neuropathy: a meta-analysis.
Pregabalin is considered to be an effective treatment for painful diabetic peripheral neuropathy (DPN), but controversy exists about its efficacy and safety. We performed a meta-analysis to systematically assess the efficacy and safety of pregabalin for managing pain associated with DPN. ⋯ Our meta-analysis indicates that pregabalin is more effective than placebo for managing DPN-associated pain and other symptoms that reduce quality of life. The drug is also reasonably well tolerated.
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Acta Anaesthesiol Scand · Feb 2015
An in vitro evaluation of infusion methods using a syringe pump to improve noradrenaline administration.
International guidelines recommend noradrenaline (NA) as the vasopressor of choice to treat septic shock. The aim of this study was to determine the best way to infuse patients with NA. ⋯ A combination of a low dead-space volume extension set and a double pump method with a constant saline flow rate at 5 ml/h might be the solution to provide the most reliable NA infusion delivery.
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Acta Anaesthesiol Scand · Feb 2015
The spread of injectate during saphenous nerve block at the adductor canal: a cadaver study.
The spread of injectate during a saphenous nerve block at the adductor canal has not been clearly described. ⋯ Injection of 15 ml dye was sufficient to spread throughout the adductor canal and beyond both proximally and distally. Distinct ultrasonographic features could be identified separating a subsartorial injection from an injection within the adductor canal with consequent differences in the spread.
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Acta Anaesthesiol Scand · Feb 2015
The effects of surgical checklists on morbidity and mortality: a pre- and post-intervention study.
Surgical checklists (SCs) have been developed to enhance teamwork and facilitate handovers, thereby improving the safety of surgical patients in health care organisations. The aim of this study was to determine whether the implementation of a 39-item SC reduced mortality and surgical adverse events (AEs) in patients undergoing inpatient surgery. ⋯ The overall AE rate did not decrease significantly between the two periods. However, the rate of infectious AEs and overall AEs in patients with non-elective admissions had statistically significant reductions. Further research is needed to determine how and in which patients SC introduction can work successfully.