Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1994
Case ReportsThe Bullard laryngoscope. Reports of two cases of difficult intubation.
The Bullard laryngoscope is a new combination of a fibreoptic light source and an anatomically shaped rigid blade, to aid visualization of the larynx. We present two patients with expected severe difficult endotracheal intubation and describe their anaesthetic management. Our experience confirms previous observations which showed that the Bullard laryngoscope provides an excellent view of the vocal cords in patients with severe difficult airways.
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Acta Anaesthesiol Scand · Apr 1994
Haemodynamic effects of pneumoperitoneum and the influence of posture during anaesthesia for laparoscopic surgery.
The laparoscopic operating technique is being applied increasingly to a variety of intra-abdominal operations. Intra-abdominal gas insufflation, i.e. pneumoperitoneum (PP), is then used to allow surgical access. The haemodynamic effects of PP in combination with different body positions have not been fully examined. ⋯ CI showed a certain dependency on filling pressures. It is concluded that PP causes signs of elevated preload and afterload. The combination of PP and a head-up tilt is associated only with signs of an elevated afterload.(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · Apr 1994
The effect of position and different manoeuvres on internal jugular vein diameter size.
Internal jugular vein (IJV) cannulation is a popular approach for central venous access as it has few complications, of which failure to locate the vein and carotid artery puncture are the most common. A variety of manoeuvres and body positioning has been used to maximise IJV size and thereby increase cannulation success rate and decrease complications. Realtime 2D ultrasound can be used to view neck vascular anatomy in vivo and allow IJV size to be measured. ⋯ Carotid artery palpation and full neck extension reduced its diameter considerably. Increasing Trendelenberg increased diameter. Abdominal binder and the Valsalva manoeuvre were the most efficient methods of increasing its size.
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Acta Anaesthesiol Scand · Feb 1994
Randomized Controlled Trial Clinical TrialMorphine does not affect laser induced warmth and pin prick pain thresholds.
The aim of this double-blind, placebo-controlled study was to evaluate the effect of intravenously administered morphine in humans using an argon laser to induce experimental pain. Thirty volunteers were randomised to receive a total of 0.15 mg.kg-1 morphine intravenously or saline. The argon laser was used to determine the possible change in warmth thresholds and pin prick pain thresholds. ⋯ The pinprick pain thresholds of the morphine group increased 9.4% (P < or = 0.05) from baseline (1.39 W +/- 0.7 W) while the corresponding thresholds of the placebo group was 4.6% (P > or = 0.05) (baseline: 1.73 W +/- 0.44 W). The differences seen between the morphine group and the placebo group were not statistically significant and thus it was demonstrated that morphine had no effect of either the feeling of warmth or the pain elicited by the argon laser. The present study supports other investigations and clinical experience suggesting that intermittent pain is not relieved by morphine unlike continuous pain, which can be relieved by morphine.
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Acta Anaesthesiol Scand · Feb 1994
Randomized Controlled Trial Clinical TrialThe effects of regional anaesthesia for caesarean section on maternal and fetal blood flow velocities measured by Doppler ultrasound.
We studied the effects of spinal anaesthesia (Group S), epidural anaesthesia (Group E), and combined spinal and epidural anaesthesia (Group SE), on maternal and fetal blood flow in 24 healthy parturients (n = 8/group) with uncomplicated singleton pregnancies using Doppler technique. Prior to the induction of anaesthesia, the patients were prehydrated with balanced electrolyte solution 15 ml.kg-1 over a period of 15 min. After the induction of regional anaesthesia, the systolic blood pressure was maintained within 15% limits of the preoperative values using prophylactic etilefrine infusion in Groups S and SE. ⋯ Rapid intravenous prehydration had no effects on uteroplacental or fetal circulation as indicated by unaltered uterine, umbilical, and fetal middle cerebral artery PIs. After the onset of T7 analgesia, the uterine artery PI was increased in Group S indicating increased uterine vascular resistance while no changes occurred in Groups E and SE. No adverse effects were observed on the neonates as indicated by the Apgar score and the umbilical artery and vein acid-base status in any of the groups.