Acta anaesthesiologica Scandinavica
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Eight different epidural needles (Tuohy Everett, Pitkin, Braun Perifix and Portex in 16-gauge, and Becton Dickinson Crawford, Becton Dickinson B-D, Monoject and Portex in 18-gauge) were evaluated using a scanning electron microscope and spectral x-ray analysis. Differences were noted in the metal composition, between disposable and reusable needles with respect to molybdenum content. ⋯ The Portex 16-gauge had the best needle/stilette fit at its bevel. The hardness of the metal was found to be satisfactory in all the needles.
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Acta Anaesthesiol Scand · Jan 1987
Randomized Controlled Trial Comparative Study Clinical TrialPropofol vs thiopentone as anaesthetic agents for short operative procedures.
In a randomized open study, 120 healthy female patients were included. For short gynaecological procedures they were anaesthetized with either propofol 2.5 mg X kg-1 (n = 60) or thiopentone 5 mg X kg-1 (n = 60) in combination with nitrous oxide/oxygen (67%/33%). Supplementary doses of propofol (10-20 mg) or thiopentone (25-50 mg) were given when necessary during the procedure. ⋯ Otherwise, the side-effects were similar in both groups. We conclude that propofol is similar to thiopentone in its anaesthetic qualities during induction and maintenance of short anaesthetic procedures. Propofol was associated with a more rapid emergence from anaesthesia than thiopentone.
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Acta Anaesthesiol Scand · Jan 1987
Comparative StudyHeating efficacy of external heat supply during and after open-heart surgery with hypothermia.
Heat balance after cardiac surgery with hypothermic cardiopulmonary bypass (CPB) was studied in 156 patients. In spite of rewarming during CPB there was residual hypothermia at the end of operation. This heat deficit could not be prevented by intraoperative use of a heating mattress at 38 degrees C and/or heated (39 degrees C) humidified inspired gases. ⋯ Also, with this radiant heat postoperative shivering was almost abolished. With a combination of radiant heat and heated, humidified gases (n = 50), the postoperative heat balance was improved somewhat further. For patients treated with radiant heat, postoperative rewarming was accomplished in a shorter time and almost without active endogenous muscular thermogenesis, as was evident by the great reduction in postoperative shivering.
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Acta Anaesthesiol Scand · Jan 1987
Comparative StudyIntermittent and continuous positive-pressure ventilation in the prophylaxis of endotoxin-induced lung insufficiency. A study in pigs.
The effects of intermittent and continuous positive-pressure ventilation (IPPV and CPPV) instituted prophylactically were evaluated in a porcine model of endotoxin-induced pulmonary and cardiovascular failure. Pigs under ketamine anaesthesia were infused i.v. with E. coli endotoxin over 6 h. Twenty animals, breathing air spontaneously, received endotoxin without treatment. ⋯ All animals treated with CPPV died during the observation period. These results indicate that prophylactic IPPV and CPPV may counteract the development of sepsis-induced lung insufficiency in man. However, it must be emphasized that adequate cardiovascular support is essential in optimizing the treatment.
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Acta Anaesthesiol Scand · Jan 1987
Circulatory effects of short-term hypercapnia during high thoracic epidural anaesthesia in elderly patients.
Circulatory changes and the degree of sympathetic block were evaluated in 15 elderly patients with high thoracic epidural anaesthesia (T1-T5). Bupivacaine 5-6 ml 0.5% was injected via an epidural catheter at the T3-level. The quality of the sympathetic block was determined with the Valsalva manoeuvre. ⋯ During hypercapnia, heart rate and arterial blood pressure increased both before and after established TEA. Thus the block of the sympathetic innervation to the heart with a high TEA using 0.5% bupivacaine was not sufficient to prevent mobilization of circulatory reserves during sympathetic stimulation. The most likely explanation is considered to be the lack of neural block of the efferent nerves leading to the adrenal medulla and the peripheral vascular bed.