Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Dec 1984
Natural killer cell activity in patients undergoing upper abdominal surgery: relationship to the endocrine stress response.
Natural killer (NK) cell activity and the endocrine response during and after parietal cell vagotomy were studied in two groups of patients receiving either epidural analgesia extending from S5 to Th4 + general anaesthesia (Group I), or general anaesthesia (Group II). NK cell activity of unseparated mononuclear cells in peripheral blood was measured against K-562 target cells in a 51Cr-release assay. NK cell activity increased in the same way in both groups in relation to premedication, anaesthesia and surgery (P less than 0.01). ⋯ A significant increase in plasma adrenaline and serum prolactin was found in both groups during anaesthesia and surgery. The findings indicate that NK cell activity during upper abdominal surgery is modified in almost the same way during two different anaesthetic techniques, one of which partly seemed to block the endocrine surgical stress response. The fluctuations in NK cell activity were not correlated to the changes measured in hormone concentrations.
-
Acta Anaesthesiol Scand · Dec 1984
Comparative StudyThe measurement of tidal volumes in spontaneously breathing children during general anaesthesia using a Haloscale infant Wright respirometer.
The accuracy of tidal volume measurements made with a Wright Haloscale infant respirometer in children breathing spontaneously during general anaesthesia was assessed by a bench test. The tidal volumes and peak flow rates of 20 spontaneously breathing, anaesthetised children were measured with a pneumotachograph before and during surgery, and similar volumes, at the same flow rates, were delivered by a calibrated syringe simultaneously to the respirometer and a pneumotachograph. The results reveal that the mean (+/- s.d.) peak gas flow rates of children aged 6 years and less, 7.5 (+/- 1.6) and 9.3 (+/- 0.1) l/min before surgery and during surgery respectively, are significantly less than the peak flow rates, 11.3 (+/- 1.0) and 11.9 (+/- 1.5) before and during surgery, respectively, of children aged more than 6 years; and that the respirometer underestimates tidal volume by 10% when the peak flow rate is 11 l/min, and the percentage error in tidal volume estimation by the respirometer increases as the peak gas flow declines below 10 l/min.
-
Acta Anaesthesiol Scand · Oct 1984
Comparative StudyDiazepam does not prevent succinylcholine-induced fasciculations and myalgia. A comparative evaluation of the effect of diazepam and d-tubocurarine pretreatments.
To determine the effectiveness of diazepam pretreatment in preventing succinylcholine (SCh)-induced fasciculations and body pains, 587 patients were randomly allocated to six groups. Patients in Group I received no pretreatment and served as controls. Patients in Groups II and III were pretreated with 0.05 mg/kg of diazepam either 4-5 min (Group II) or 8-10 min (Group III) prior to SCh administration. ⋯ There was no statistically significant difference in the incidence of body pains by virtue of site of operation, age, sex, and inpatient/outpatient status. It is concluded that the problem of postoperative myalgia is significant and that dTc pretreatment is the effective method for prevention of fasciculations and postoperative myalgia. Diazepam pretreatment was ineffective for the prevention of fasciculations and myalgia.
-
Heat loss during anesthesia and operation and subsequent hypothermia will increase the postoperative oxygen demand and may endanger patients with restricted cardiopulmonary reserves. Forty patients scheduled for intra-abdominal aortic surgery and 40 patients scheduled for peripheral vascular surgery on the lower limbs were investigated using a warming blanket, humidified heated inspired anesthetic gases at 37-40 degrees C, or both these methods together. A fourth group of patients received no active warming. ⋯ The combination of humidified and heated inspired gases and a warming blanket gave significantly better heat preservation after 40 min (P less than 0.05). Patients undergoing peripheral vascular surgery had similar but smaller drops in temperature with the different types of warming procedures employed. The differences in temperature between the intra-abdominal and extra-abdominal operations were statistically significant after 3 h (P less than 0.05).
-
Acta Anaesthesiol Scand · Oct 1984
Laryngospasm during anaesthesia. A computer-aided incidence study in 136,929 patients.
With the aid of a computerized anaesthetic record-keeping system, the incidence of laryngospasm during anaesthesia was studied, in order to quantify the risk of this complication. 136,929 patients given 156,064 anaesthetics were studied. There were 1,232 cases of laryngospasm recorded in 1,197 patients. The incidence of laryngospasm was calculated in subgroups characterized by age, sex, preanaesthetic conditions, premedication, anaesthetic technique, type of surgery and concomitant complication. ⋯ Figures exceeding 25 laryngospasms in 1,000 patients were seen in the age group 1-3 months and in children undergoing appendicectomy, oral endoscopy and plastic surgery, when tracheal intubation had been performed and when a gastrointestinal tube was used. In the age group 50-59 years, an incidence exceeding 25 in 1,000 patients was seen when there had been preoperative airway obstruction and in females when the anaesthetic technique included spontaneous breathing and face mask, or apneic oxygenation. Dilatation of the anal sphincter and mediastinoscopy in males were also associated with an increased incidence of laryngospasm.