Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2015
ReviewPrevention of hospital-acquired hyponatraemia: individualised fluid therapy.
Large amounts of fluids are daily prescribed to hospitalised patients across different medical specialities. Unfortunately, inappropriate fluid administration commonly causes iatrogenic hyponatraemia with associated increase in morbidity and mortality. ⋯ The occurrence of hospital-acquired hyponatraemia may be reduced by prescribing fluids, type and amount, with the same dedication as shown for other drugs.
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Acta Anaesthesiol Scand · Sep 2015
ReviewNerve localization techniques for peripheral nerve block and possible future directions.
Ultrasound guidance is now a standard nerve localization technique for peripheral nerve block (PNB). Ultrasonography allows simultaneous visualization of the target nerve, needle, local anesthetic injectate, and surrounding anatomical structures. Accurate deposition of local anesthetic next to the nerve is essential to the success of the nerve block procedure. Due to limitations in the visibility of both needle tip and nerve surface, the precise relationship between needle tip and target nerve is unknown at the moment of injection. Importantly, nerve injury may result both from an inappropriately placed needle tip and inappropriately placed local anesthetic. The relationship between the block needle tip and target nerve is of paramount importance to the safe conduct of peripheral nerve block. ⋯ Until it is known how best to define the relationship between needle and nerve at the moment of injection, some common sense principles are suggested.
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Acta Anaesthesiol Scand · Sep 2015
Observational StudyAcute alcohol intoxication and bispectral index monitoring.
Bispectral index (BIS) monitoring is commonly used to decrease the risk of awareness during anaesthesia. We aimed to determine the relationship between blood alcohol concentration and brain function (as measured by BIS) in healthy adults. ⋯ In healthy young adults, we found a moderate correlation between venous blood alcohol concentration and BIS. This suggests that acute alcohol consumption can decrease BIS. This information may be relevant when providing anaesthesia to intoxicated patients who require urgent or time-critical surgery, although certain limitations of this study should be kept in mind.