Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2017
ReviewA systematic review of the analgesic efficacy of cannabinoid medications in the management of acute pain.
Cannabinergic medications have been postulated to demonstrate efficacy in the management of pain. The aim of this systematic review was to assess the analgesic efficacy and adverse effects of cannabinoids when used for the management of acute pain. ⋯ On the basis of the available randomized controlled trial evidence, cannabinoids have no role in the management of acute pain.
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Acta Anaesthesiol Scand · Mar 2017
Multicenter StudyPain prevalence in hospitalized children: a prospective cross-sectional survey in four Danish university hospitals.
Pain management in hospitalized children is often inadequate. The prevalence and main sources of pain in Danish university hospitals is unknown. ⋯ This study reveals high pain prevalence in children across all age groups admitted to four Danish university hospitals. The majority of children in moderate to severe pain did not have a documented pain assessment, and evidence-based pharmacological and/or integrative ('non-pharmacological') measures were not systematically administered to prevent or treat pain. Thus, practice changes are needed.
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Acta Anaesthesiol Scand · Mar 2017
Pharmacokinetics of 400 mg ropivacaine after periarticular local infiltration analgesia for total knee arthroplasty.
Although considered safe, no pharmacokinetic data of high dose, high volume local infiltration analgesia (LIA) with ropivacaine without the use of a surgical drain or intra-articular catheter have been described. The purpose of this study is to describe the maximum total and unbound ropivacaine concentrations (Cmax , Cu max ) and corresponding maximum times (Tmax , Tu max ) of a single-shot ropivacaine (200 ml 0.2%) and 0.75 mg epinephrine (1000 μg/ml) when used for LIA in patients for total knee arthroplasty. ⋯ Although great inter-individual variability was found between the maximum ropivacaine concentrations, both maximum total and unbound serum concentrations of ropivacaine remained well below the assumed systemic toxic thresholds of 4.3 and 0.56 μg/ml.
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In Denmark, organ donation-rates are below the average in the western countries. We investigated the donor potential and identified barriers toward organ donation in a Danish university hospital. ⋯ It would be possible to raise the donation rate considerably if patients with donation potential are intubated and admitted to the ICU. When active treatment is considered withdrawn, possibility of organ donation should be evaluated, and the next of kin be approached by experienced staff.
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Acta Anaesthesiol Scand · Mar 2017
Operating unit time use is associated with anaesthesia type in below-knee surgery in adults.
Peripheral nerve blocks could reduce the operating unit and theatre time spent on high-risk patients who are particularly vulnerable to complications of general anaesthesia or have medications that prevent application of central neuraxial blocks. ⋯ Peripheral nerve block anaesthesia reduces time spent in the operating unit and can reduce time spent in the operating theatre if induced in holding area outside of theatre.