Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 1984
Randomized Controlled Trial Clinical TrialHypotensive anesthesia, thromboprophylaxis and postoperative thromboembolism in total hip arthroplasty.
A prospective study was performed in 120 patients undergoing total hip arthroplasty. The patients were randomly allocated to four groups. The first two groups had nitroprusside-induced hypotensive anesthesia with either a fixed combination of sodium heparin and dihydroergotamine mesylate (HDHE) or dextran 70. ⋯ There was a lower incidence of pulmonary embolism in patients with HDHE and normotensive anesthesia. Major wound hematomas were noted postoperatively in 12% of the patients receiving HDHE, whereas no major hematomas developed following dextran prophylaxis. No anaphylactic reaction was noted from dextran 70, using hapten-dextran prophylaxis.
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Acta Anaesthesiol Scand · Oct 1984
Lateral positioning with differential lung ventilation and unilateral PEEP following unilateral acid aspiration in the dog.
Body position can significantly alter the efficiency of gas exchange following unilateral lung injury. We systematically examined three positions during differential lung ventilation with unilateral positive end-expiratory pressure (PEEP) following unilateral hydrochloric acid aspiration in the dog. Twelve mongrel dogs were intubated with a double-lumen endobronchial tube and mechanically ventilated with a microcomputer-controlled pair of ventilators. ⋯ There was no significant difference between the three positions with regard to PaO2 (F (2, 10) = 1.60, P = 0.25) of venous admixture (F (2, 10) = 0.49, P = 0.63). Our data indicated that position did not alter oxygenation. This was probably due to the use of differential ventilation with unilateral PEEP which eliminated redistribution of ventilation between the two lungs and minimized position-dependent changes in pulmonary blood flow.
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Acta Anaesthesiol Scand · Aug 1984
Comparative StudyAtropine vs glycopyrrolate during reversal of pancuronium block in patients anaesthetized with halothane.
Atropine 0.015 mg kg-1 and glycopyrrolate 0.0075 mg kg-1 were compared as antimuscarinic agents during reversal of pancuronium block with neostigmine 0.03 mg kg-1 in 30 patients anaesthetized with thiopental-N2O-halothane and undergoing minor surgery. In patients treated with atropine-neostigmine, the frequencies of bradycardia and junctional rhythm were relatively high and about the same as those reported by us previously in patients anaesthetized with thiopental-N2O-fentanyl. As in our previous study, glycopyrrolate seemed to have advantages over atropine during reversal of pancuronium block: the incidences of bradycardia and junctional rhythm were significantly less in patients treated with glycopyrrolate. Recovery from anaesthesia, as assessed by the awakening after discontinuation of N2O and halothane administration, and the incidence of postoperative nausea and vomiting, were not significantly different between the atropine and glycopyrrolate groups.
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Acta Anaesthesiol Scand · Aug 1984
Randomized Controlled Trial Comparative Study Clinical TrialEnflurane, isoflurane and the eye.
The intra-ocular pressure was monitored in ophthalmological patients in whom nitrous oxide/oxygen anaesthesia was supplemented with an inspired concentration of 1% enflurane (10 patients) or 0.7% isoflurane (10 patients). These concentrations are proportionate to 0.6 MAC in oxygen. ⋯ There was no significant difference between agents. Isoflurane offers an alternative to enflurane in surgery when intra-ocular pressure is of importance.
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Acta Anaesthesiol Scand · Aug 1984
Intervillous blood flow during caesarean section with prophylactic ephedrine and epidural anaesthesia.
We administered a 15 mg i.v. bolus of ephedrine at the commencement of epidural blockade to nine healthy parturients scheduled for elective caesarean section. Nine other patients did not receive prophylactic ephedrine before epidural anaesthesia (control group). Lactated Ringer solution, 30 ml/kg, was infused before and during blockade, and left uterine displacement was used to minimize aortocaval compression. ⋯ S.). In the ephedrine group there was in this preliminary study a trend to increasing IBF during falling perfusion pressure (MAP). The results of this preliminary study suggest that ephedrine will not affect IBF, but to prevent maternal hypotension ephedrine should be used as an i.v. infusion instead of a bolus injection.