Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 1990
Randomized Controlled Trial Clinical TrialHeat and moisture exchangers and the body temperature: a peroperative study.
The importance of conditioning the inhaled gas for maintaining the body temperature during artificial respiration was investigated. The mean body temperature (MBT) was deduced from readings from five measuring sites, four of which were situated at the skin and the fifth in the rectum. Temperature recordings were made every 15th min. ⋯ Our finding correlated fairly well with a predicted reduction of heat loss of 26.0 kJ/h for the type of HME used. A certain margin of error seemed to be inevitable in measuring body temperatures, and the reason for this is discussed. Our results support the fact that the investigation is adequately designed, and that the heat conserved with an HME is rather low.
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Acta Anaesthesiol Scand · Oct 1990
Anaesthesia in malignant hyperthermia-susceptible patients without dantrolene prophylaxis: a report of 30 cases.
The intra- and postoperative course of 30 anaesthetics in 24 MH-carriers verified by in vitro contracture tests is reported. None of the patients received dantrolene prophylactically and only agents known to be nontriggers were used for anaesthesia. Neither MH-related changes in perioperative heart rates, body temperatures, and CK levels nor any other symptoms of MH were observed. We conclude that the prophylactic use of dantrolene is not necessary in patients suspected to be prone to MH if triggering agents are avoided and the patients are closely monitored.
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Data about forty-six "first anaesthetics" have been collected from the literature. This makes it possible to get an impression of how fast the news of either anaesthesia spread to Europe and other parts of the world. Most European countries had the news within 4 months and other parts of the world within 9 months. The use of ether seems not to have spread faster in the US than in Europe.
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The incidence of emetic episodes during the first 24 h after anaesthesia was studied prospectively in 485 children aged 0-16 years in relation to age, premedication, type of induction, type and duration of anaesthesia, type of surgery and use of postoperative analgesics. The incidence of emetic episodes was 25% in the whole material. The majority of the emetic episodes were recorded after the immediate recovery period. ⋯ Nausea and vomiting was most common after squint surgery (75%) and least common after endoscopies (17%). Neither premedication with diazepam nor the method of induction (thiopentone, i.v., thiopentone rectally, inhalation with halothane) influenced the incidence of nausea. For the same type of surgery, maintenance of anaesthesia with halothane resulted in a lower incidence of nausea than anaesthesia with fentanyl-pancuronium.
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Acta Anaesthesiol Scand · Aug 1990
Randomized Controlled Trial Comparative Study Clinical TrialContinuous blockade of the lumbar plexus after knee surgery: a comparison of the plasma concentrations and analgesic effect of bupivacaine 0.250% and 0.125%.
In 20 patients a continuous block of the lumbar plexus was administered after knee-joint surgery, and the analgesic effect of two different concentrations of bupivacaine was compared. The same volume of bupivacaine was given to both groups of patients: a bolus dose of 0.4 ml/kg, 0.5% or 0.25%, followed by infusion of 0.14 ml/kg/h, 0.25% or 0.125%, respectively, via a catheter placed in the neurovascular fascial sheath of the femoral nerve according to the "3-in-1 block" technique. The median morphine consumption during the first 16 h postoperatively was 6.0 mg when bupivacaine 0.5/0.25% was used and 9.5 mg when 0.25/0.125% was used. ⋯ The visual analogue pain scores were also similar in the two groups (P greater than 0.05). All plasma concentrations were below 4 micrograms/ml, the highest concentration measured being 3.6 micrograms/ml. It is concluded that when used for a continuous block of the lumbar plexus after knee-joint surgery, bupivacaine in a concentration of 0.125% offers the same pain relief as a concentration of 0.25%, and the risk of toxic reactions is reduced.