Acta anaesthesiologica Scandinavica
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Two patients with acute severe asthma, who failed to respond to conventional therapy, were given intravenous ketamine in sub-anaesthetic doses with good results. A bolus dose of 0.75 mg/kg was followed by the same dose over 10 min with relief of bronchospasm in both cases. ⋯ Intravenous ketamine can be used to relieve acute intractable bronchospasm provided expert anaesthetic help is at hand. A review of the literature concerning its use in such situations is also presented.
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Acta Anaesthesiol Scand · Jan 1992
Randomized Controlled Trial Clinical TrialEpidural bupivacaine, sufentanil or the combination for post-thoracotomy pain.
Analgesia with epidural bupivacaine, sufentanil or the combination was studied in 50 patients who had undergone thoracotomy. During operation all patients received an initial dose of bupivacaine 0.5% with adrenaline 5 micrograms.ml-1 (5-10 ml) by thoracic epidural catheter. One hour later the patients were divided into three groups: the bupivacaine group (bupivacaine 0.125%), the sufentanil group (50 micrograms sufentanil in 60 ml normal saline) and the combination group (50 micrograms sufentanil in 60 ml bupivacaine 0.125%). ⋯ The sufentanil group had much better pain scores, but on exercise these patients experienced more pain than the combination group. The combination group had, overall, better pain scores. In the combination group, there were better respiratory results.
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Acta Anaesthesiol Scand · Jan 1992
Comparative StudyDoes the anesthetic method influence the postoperative breathing pattern and gas exchange in hip surgery? A comparison between general and spinal anesthesia.
We studied the effects of elective hip surgery, performed under either spinal (SA, n = 10) or general anesthesia (GA, n = 10), on breathing pattern and gas exchange. Measurements were made with respiratory inductive plethysmograph and indirect calorimetry in two positions before and after surgery. The method of anesthesia had no effect on the severity of postoperative hypoxemia. ⋯ The contribution of rib cage to tidal volume increased postoperatively in the supine position (P less than 0.001; SA from 32.6% +/- 10.3 to 46.3% +/- 7.5, GA from 36.5 +/- 16.4 to 48.5% +/- 15.4). CO2 production, oxygen consumption and energy expenditure remained unchanged. The postoperative changes in breathing pattern are related to the operation, not to the type of anesthesia and do not explain the alterations in gas exchange.
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Acta Anaesthesiol Scand · Jan 1992
A new ventilator converter with the Siemens Servo Ventilator--evaluation in a lung model.
A ventilator converter device (Anmedic) for connecting a non-rebreathing ventilator (Servo Ventilator 900 B; Siemens-Elema) to a circle anaesthesia system was evaluated in a lung model. Recorded minute ventilation was slightly lower than dialled in most cases. We furthermore found inadequate expiratory expansion of the ventilator converter bellows, with progressive loss of tidal volume and consequently recorded minute volume, when fresh gas flow to the circle system was low (1 l.min-1), expiratory time was short (less than 40%) and respiratory obstruction was present.
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Acta Anaesthesiol Scand · Jan 1992
Comparative StudyPost-dural puncture headache in young orthopaedic in-patients: comparison of a 0.33 mm (29-gauge) Quincke-type with a 0.7 mm (22-gauge) Whitacre spinal needle in 200 patients.
The incidence of postdural puncture headache (PDPH) following spinal anaesthesia with a 0.33 mm (29-gauge) and two types of 0.7 mm (22-gauge) Whitacre needles was investigated in 400 patients less than 40 years old. The incidence of PDPH was 2% in the 0.33 mm group, and 3.5% in the 0.7 mm group. ⋯ The failure rate was significantly higher in the 0.33 mm group (8.5% vs 2%) than in the 0.7 mm group (P less than 0.05). It is concluded that the 0.33 mm needle is associated with a low incidence of PDPH in young patients, but has a significantly higher failure rate than the Whitacre 0.7 mm needle, which is also a suitable choice in this age-group because of its ease of handling and the low incidence of PDPH.