Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 2017
Clinical, nociceptive and psychological profiling to predict acute pain after total knee arthroplasty.
Pre-operative identification of high-pain responders for acute pain after total knee arthroplasty (TKA) could lead to targeted analgesic trials and individualized analgesic strategies to improve recovery and potentially reduce the risk of persistent post-surgical pain. The aim of this study was to use simple clinical tests and questionnaires to identify predictive nociceptive and psychological factors for acute post-TKA pain. ⋯ Pre-operative widespread pressure pain hypersensitivity and pain catastrophizing are predictive of moderate severe post-TKA pain. If validated in a larger population, the clinically applicable tests should be considered in future interventions aiming to minimize post-operative pain in high-risk patients.
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Acta Anaesthesiol Scand · Jul 2017
Comparative Study Observational StudyNorepinephrine reduces arterial compliance less than phenylephrine when treating general anesthesia-induced arterial hypotension.
During general anesthesia, arterial hypotension is frequent and may be an important contributor to perioperative morbidity. We assessed the effect of a 5 μg bolus of Norepinephrine (NA) when compared with 50 μg bolus of Phenylephrine (PE) administered to treat hypotension during maintenance anesthesia, on MAP, derived cardiac output and arterial stiffness parameters. ⋯ This study suggests that 5 μg of NA administered as a bolus in a peripheral venous line could treat general anesthesia-induced arterial hypotension with a smaller decrease in SV and arterial compliance when compared to PE.
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Acta Anaesthesiol Scand · Jul 2017
Objective neuromuscular monitoring of neuromuscular blockade in Denmark: an online-based survey of current practice.
Neuromuscular blocking agents are commonly used during general anaesthesia but can lead to postoperative residual neuromuscular blockade and associated morbidity. With appropriate objective neuromuscular monitoring (objNMM) residual blockade can be avoided. In this survey, we investigated the use of objNMM in Denmark. ⋯ In this survey, Danish anaesthetists frequently, in an international perspective, use objNMM, but the use is often associated with technical difficulties.
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Acta Anaesthesiol Scand · Jul 2017
Does obesity complicate regional anesthesia and result in longer decision to delivery time for emergency cesarean section?
Maternal obesity can cause problems with anesthesia and surgery which may be reflected in emergency cesarean sections (CS) as an increased decision-to-delivery interval (DDI). ⋯ Higher BMI was associated with longer DDI and more regional anesthesia failures. Epidural top-up was faster than CSE for establishing CS anesthesia.
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Acta Anaesthesiol Scand · Jul 2017
Pharmacokinetics after a single dose of naloxone administered as a nasal spray in healthy volunteers.
There is increasing interest in the use of intranasal naloxone to reverse adverse opioid effects during management of procedural pain in children and in adults after overdose. There are limited data on the pharmacokinetics of intranasal naloxone so in this study we aimed to detail the pharmacokinetic profile of the commercially marketed injectable solution of naloxone 0.4 mg/ml when administered as an intranasal spray. ⋯ Our results show a faster uptake of intranasal naloxone to maximum concentration compared with previous studies although with a marked variation in maximum concentration. The findings are consistent with our clinical experience of the time profile for reversing the effects of sufentanil sedation in children.