Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2016
Review Comparative StudyComparing efficacy and safety of fibrinogen concentrate to cryoprecipitate in bleeding patients: a systematic review.
Bleeding is associated with the depletion of fibrinogen, thus increasing the risk of coagulopathy, further bleeding and transfusion requirements. Both fibrinogen concentrate and cryoprecipitate replenish low plasma fibrinogen levels. This systematic review aims to identify and evaluate evidence of efficacy and safety of fibrinogen concentrate and cryoprecipitate in bleeding patients. ⋯ The available evidence directly comparing fibrinogen concentrate to cryoprecipitate is sparse and with high risk of bias. Recommendation of one product over the other for fibrinogen substitution in the bleeding patient with acquired hypofibrinogenaemia is currently not possible. Future research should guide us towards evidence-based decisions of product superiority.
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Acta Anaesthesiol Scand · Sep 2016
Randomized Controlled Trial Comparative StudyManual vs. pressure-controlled facemask ventilation for anaesthetic induction in paralysed children: a randomised controlled trial.
During anaesthetic induction with a facemask, the inconsistent inspiratory flow with manual ventilation (MV) raises the peak airway pressure (PAP), which can be significantly higher than PAP during pressure-controlled ventilation (PCV). In this study, PAP was compared between MV and PCV at the same tidal volume of 8-10 ml/kg during facemask ventilation for anaesthetic induction in children. The occurrence of gastric insufflation (GI) was evaluated with ultrasonography and stethoscopic auscultation. ⋯ Although PCV provided lower PAP than MV at the same tidal volume, the risk of GI may not be eliminated during facemask ventilation in paralysed small children.
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Acta Anaesthesiol Scand · Sep 2016
ReviewPost-operative cognitive dysfunction at 3 months in adults after non-cardiac surgery: a qualitative systematic review.
Post-operative cognitive dysfunction is defined as a decline in cognitive functions that occurs after surgery, but different diagnostic criteria and incidences have been reported in medical literature. Our aim was to determine incidence of post-operative cognitive dysfunction 3 months after non-cardiac surgery in adults. ⋯ Post-operative cognitive dysfunction in patients is frequent, especially in patients over 60 years old. Limitations include methodological differences in studies. Efforts must be made to reach a consensus in definition and diagnosis for future research.
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Acta Anaesthesiol Scand · Sep 2016
Randomized Controlled TrialThe effect of chlorzoxazone on acute pain after spine surgery. A randomized, blinded trial.
Chlorzoxazone is a muscle relaxant administered for musculoskeletal pain, and as an analgesic adjunct for post-operative pain. Chlorzoxazone for low back pain is currently not advised due to the lack of placebo-controlled trials. We explored the effect of chlorzoxazone on acute pain after spine surgery. ⋯ No analgesic effect of single-dose chlorzoxazone was demonstrated in patients with acute pain after spine surgery. Based on these findings, chlorzoxazone cannot be recommended for immediate treatment of acute pain after such procedures.
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Acta Anaesthesiol Scand · Sep 2016
Randomized Controlled TrialPain rather than induced emotions and ICU sound increases skin conductance variability in healthy volunteers.
Assessing pain in critically ill patients is difficult. Skin conductance variability (SCV), induced by the sympathetic response to pain, has been suggested as a method to identify pain in poorly communicating patients. However, SCV, a derivate of conventional skin conductance, could potentially also be sensitive to emotional stress. The purpose of the study was to investigate if pain and emotional stress can be distinguished with SCV. ⋯ In healthy volunteers, NSCF appears to reflect ongoing autonomous reactions mainly to pain and to a lesser extent, reactions to emotion induced with IAPS pictures or ICU sound.