Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2015
Observational StudyOne-year outcome after prehospital intubation.
The aim of physician staffed emergency medical services (EMS) is to supplement other EMS units in the care of prehospital patients. The need for advanced airway management in critical prehospital patients can be considered as one indicator of the severity of the patient's condition. Our primary aim was to study the long-term outcome of critically ill patients (excluding cardiac arrest) who were intubated by EMS physicians in the prehospital setting. ⋯ The majority of the study patients had a favourable neurological recovery with independent life at 1 year after the incident. More than 80% of all deaths occurred within 30 days of the incident.
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Acta Anaesthesiol Scand · Apr 2015
Observational StudyDeep neuromuscular block reduces intra-abdominal pressure requirements during laparoscopic cholecystectomy: a prospective observational study.
Laparoscopic surgery causes specific post-operative discomfort and intraoperative cardiovascular, pulmonary, and splanchnic changes. The CO2 pneumoperitoneum-related intra-abdominal pressure (IAP) remains one of the main drivers of these changes. We investigated the influence of deep neuromuscular blockade (NMB) on IAP and surgical conditions. ⋯ We found an almost 25% lower IAP after a deep NMB compared with no block in laparoscopic cholecystectomy. Younger and female patients appear to benefit more from deep neuromuscular blockade to reduce IAP.
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Acta Anaesthesiol Scand · Apr 2015
Low Apgar score, neonatal encephalopathy and epidural analgesia during labour: a Swedish registry-based study.
Maternal intrapartum fever (MF) is associated with neonatal sequelae, and women in labour who receive epidural analgesia (EA) are more likely to develop hyperthermia. The aims of this study were to investigate if EA and/or a diagnosis of MF were associated to adverse neonatal outcomes at a population level. ⋯ Diagnosis of MF was associated with low AS and neonatal encephalopathy, whereas EA was only associated with low AS and not with neonatal encephalopathy. The found associations might be a result of confounding by indication, which is difficult to assess in a registry-based population study.
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Acta Anaesthesiol Scand · Apr 2015
Case ReportsSevere hoarseness associated with the streamlined liner of the pharyngeal airway (SLIPA(TM) ).
Hoarseness is a common post-operative complication in patients who receive general anesthesia. In most cases, the symptoms are temporary and improve within several days. This report describes two patients with prolonged hoarseness following use of the streamlined liner of the pharyngeal airway (SLIPATM). ⋯ In the second case, we report on a 65-year-old male patient who was scheduled for a laparoscopic cholecystectomy. Left vocal fold paralysis or paresis resulting from recurrent laryngeal nerve injury associated with use of a SLIPA™ caused persistent hoarseness. It should be noted that recurrent laryngeal nerve injury or arytenoid cartilage dislocation are possible complications associated with use of the SLIPATM in case of persistent hoarseness.