Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2023
Observational StudyThe optimum time for intravenous cannulation after induction with Sevoflurane in children premedicated with Dexmedetomidine.
Inhalation anesthesia is a frequently used method for anesthesia induction, especially in young children. No information is available on the optimum time for safe intravenous cannulation after inhalational induction in children with dexmedetomidine premedication. The purpose of the present study was to determine the optimal time for intravenous cannulation after induction of anesthesia with sevoflurane and nitrous oxide in children premedicated with intranasal dexmedetomidine. ⋯ In conclusion, we suggest that the appropriate time for cannulation is 85 s (1.45 min) after the loss of eyelash reflex in children sedated with dexmedetomidine and induction with sevoflurane and nitrous oxide-oxygen mixture.
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Acta Anaesthesiol Scand · Jan 2023
Randomized Controlled TrialSleep quality and quantity determined by polysomnography in mechanically ventilated critically ill patients randomized to dexmedetomidine or placebo.
Abnormal sleep is commonly observed in the ICU and is associated with delirium and increased mortality. If sedation is necessary, it is often performed with gamma-aminobutyric acid agonists such as propofol or midazolam leading to an absence of restorative sleep. We aim to evaluate the effect of dexmedetomidine on sleep quality and quantity. ⋯ Total sleep time and sleep efficiency were significantly increased, without elimination of REM sleep, in mechanically ventilated ICU patients randomized to dexmedetomidine, when compared to a control PSG recording performed during non-sedation/standard care.
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Acta Anaesthesiol Scand · Jan 2023
Observational StudyIncidence of conversion to general anaesthesia and need for intravenous supplementation in parturients undergoing caesarean section under spinal anaesthesia - A retrospective observational study.
Conversion from spinal anaesthesia to general anaesthesia (GA) was shown to be associated with more complications. It has been postulated that spinal injection of a low dose of local anaesthetic is a risk factor. We aimed to discover the rate of conversion from spinal anaesthesia to GA in women who received at least 10 mg heavy bupivacaine and opioids and assess its risk factors. ⋯ A small proportion of women required conversion to GA. This conversion occurred especially with emergency caesarean section and when low spinal bupivacaine doses were used.
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Acta Anaesthesiol Scand · Jan 2023
Glycemic control and blood gas sampling frequency during continuous glucose monitoring in the ICU: A before-and-after study.
Whether subcutaneous continuous glucose monitoring (CGM) can safely replace intermittent arterial blood gas glucose analyses in intensive care unit (ICU) patients remains uncertain. We aimed to compare CGM to blood gas glucose values and assess whether CGM use reduces blood gas sampling frequency and glucose variability in ICU patients with type 2 diabetes managed with liberal glucose control. ⋯ In our cohort of ICU patients with type 2 diabetes receiving liberal glycemic control, CGM showed acceptable accuracy and was associated with a reduction in blood gas sampling frequency without compromising glucose control. Lowest accuracy was observed at glucose values below 10 mmol/L and during the first 48 h of CGM use.
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Acta Anaesthesiol Scand · Jan 2023
Randomized Controlled TrialPreparing for obstetric anaesthesia - an educational randomised controlled trial comparing e-learning to written course material.
E-learning is increasingly used in postgraduate medical education. Its numerous benefits include an enhanced learning experience through learning style individualisation, interactive elements, and assessment through tests and quizzes. Current meta-analyses conclude that the overall effectiveness of e-learning is comparable to traditional teaching modalities. However, studies demonstrating its benefits are heterogeneous and of varying quality. This randomised controlled trial aims to investigate whether contemporary e-learning completed prior to a course in obstetric anaesthesia prepares the course participants better than self-study of written course material. ⋯ This blinded parallel group randomised controlled trial found a numerically small but statistically significant difference in knowledge favouring e-learning over written course material.