Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1987
Randomized Controlled Trial Clinical TrialEvaluation of the efficacy of elastic compression stockings in prevention of hypotension during epidural anaesthesia for elective caesarean section.
The ability of graduated compression elastic stockings to prevent hypotension during elective epidural caesarean section was evaluated. Twenty women were randomly assigned to two groups of ten, one group being fitted with the stockings. The incidence and degree of hypotension were the same in both groups. Graduated compression elastic stockings are of no benefit in reducing the incidence of maternal hypotension during caesarean section.
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Acta Anaesthesiol Scand · Apr 1987
Case ReportsMalignant hyperthermia during isoflurane anaesthesia. A case report.
A case of malignant hyperthermia during isoflurane anaesthesia without the use of muscle relaxants in a healthy 7-year-old girl is presented. In this case only premedication and nitrous oxide were used together with isoflurane. Thus isoflurane by itself can trigger malignant hyperthermia, even in the absence of muscle relaxants.
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Acta Anaesthesiol Scand · Apr 1987
Randomized Controlled Trial Clinical TrialPropofol emulsion for induction and maintenance of anaesthesia. A combined technique of general and regional anaesthesia.
To provide general anaesthesia with endotracheal intubation during regional blockades, three dose regimens of propofol emulsion were studied: induction 2 mg kg-1, infusion rate 9 mg kg-1 h-1 (Group 1); induction 2.5 mg kg-1, infusion rate 12 mg kg-1 h-1 (Group 2); induction 2.5 mg kg-1, infusion rate 9 mg kg-1 (Group 3). Each group comprised 10 healthy (ASA class 1 or 2) unpremedicated patients. The induction times measured from the start of injection until counting ceased (+/- 50 s) and until eye-lash reflex disappeared (+/- 80 s) showed no statistical differences between groups. ⋯ Apart from a short period of euphoria, recovery was uneventful. There was no tendency to fall asleep again. None of the combinations of induction doses and infusion rates provided good anaesthesia conditions for an acceptable number of patients.
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Acta Anaesthesiol Scand · Apr 1987
Hormonal and metabolic responses to cardiac surgery with sufentanil-oxygen anaesthesia.
The effects of sufentanil, 10 and 20 micrograms kg-1 on the hormonal and metabolic responses to coronary artery surgery were compared in 20 patients. The most important finding was that the changes in circulating beta-endorphin, ACTH, cortisol, GH, glucose, lactate and glycerol concentrations during and after cardiac surgery were similar with both doses of sufentanil. Although sufentanil prevented a significant increase in plasma beta-endorphin, ACTH and cortisol values until 6 h after cardiopulmonary bypass (CPB), a significant increase in GH secretion occurred with the onset of CPB. ⋯ Blood glucose values did not change during surgery before CPB, but started to rise with the onset of CPB and continued to increase significantly in the postoperative period. Changes in blood lactate and plasma glycerol concentrations primarily reflected the load of CPB and the effects of heparin, respectively. The results show that increasing the dose of sufentanil up to 20 micrograms kg-1 does not result in better suppression of the endocrine and metabolic changes associated with cardiac surgery.
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Acta Anaesthesiol Scand · Feb 1987
Haemodynamic effects of intravenous bupivacaine during high thoracic epidural anaesthesia.
Administration of small doses of bupivacaine epidurally at the upper thoracic level will partially block the cardiac sympathetic nerves but not the sympathetic outflow via the adrenals. Local anaesthetics have direct systemic effects on the myocardium and the systemic circulation. The present study aimed to examine the effect of high thoracic epidural anaesthesia (TEA) in elderly patients, and to examine the effect of raising plasma bupivacaine concentrations in these patients, who had earlier had the sympathetic innervation of the heart blocked by thoracic epidural anaesthesia. ⋯ After TEA was established, heart rate, mean arterial blood pressure and cardiac output decreased. When bupivacaine was given to these patients intravenously during the block, mean arterial blood pressure increased, while cardiac output decreased still more. The mechanisms behind these effects seem to be a direct constriction of the systemic blood vessels and a depressive effect on the myocardium, which was blocked from the influence of the cardiac sympathetic nerves by the high thoracic epidural block.