Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2001
Comparative StudyEffects of different preparations of propofol, diazepam, and etomidate on human neutrophils in vitro.
Intravenous anaesthetics and sedatives can influence polymorphonuclear cell (PMN) functions. Some of the drugs for sedation and anaesthesia have been alternatively dissolved in lipid solutions containing medium (MCT) and/or long chain (LCT) triglycerides. The in vitro effects of two different diazepam (benzyl-alcohol, LCT/MCT), etomidate (propylene-glycol, LCT/MCT), and propofol (LCT, LCT/MCT) preparations on respiratory burst (RB) and phagocytosis of human PMNs were studied. ⋯ The in vitro effects of diazepam, etomidate, and propofol are dependent on the solvent applied. The tested LCT/MCT preparations reduce the inhibitory effects on the bacterial killing capacity of PMNs found after incubation with propyleneglycol, benzyl-alcohol, or LCT preparations, respectively.
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Acta Anaesthesiol Scand · Feb 2001
Randomized Controlled Trial Comparative Study Clinical TrialBronchial blocker compared to double-lumen tube for one-lung ventilation during thoracoscopy.
Video-assisted thoracoscopic surgery (VATS) requires one-lung ventilation with a properly collapsed lung. This study compared the Broncho-Cath double-lumen endotracheal tube with the Wiruthan bronchial blocker to determine the advantages of one device over the other during anaesthesia with one-lung ventilation for thoracoscopy. ⋯ It took significantly longer to place a left BB than a DLT (P<0.0006) or a right BB (P<0.008). The number of initial malpositionings of the left BB was significantly greater than in the other groups (P<0.001). The quality of lung deflation was better in the BBL and in the DLT groups than in the BBR group. We conclude that for routine use during left-sided VATS, the use of a DLT is preferable to a left BB because of its greater ease of placement. For right-sided VATS, DLT and right BB showed the same facility of placement but the DLT provided a better quality of lung deflation.
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Acta Anaesthesiol Scand · Feb 2001
Randomized Controlled Trial Comparative Study Clinical TrialReversal of rocuronium with edrophonium during propofol versus sevoflurane anesthesia.
The use of volatile anesthetics for maintenance of anesthesia can enhance the action of non-depolarizing muscle relaxants and interfere with the reversal of neuromuscular blockade. In this study, we studied the antagonism of rocuronium with edrophonium-atropine during propofol- versus sevoflurane-based anesthesia. ⋯ We conclude that the clinical duration of action after a single dose of rocuronium, 0.6 mg kg(-1) i.v., was similar during both propofol- and sevoflurane-based anesthesia. However, the reversal of rocuronium-induced residual blockade was slower and more variable in the presence of sevoflurane.
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Acta Anaesthesiol Scand · Feb 2001
Randomized Controlled Trial Clinical TrialTransient neurologic symptoms after spinal anaesthesia using isobaric 2% mepivacaine and isobaric 2% lidocaine.
Transient Neurological Symptoms (TNS) syndrome following subarachnoid anaesthesia was initially associated with hyperbaric lidocaine 50 mg/ml, but has also been reported with most local anaesthetics, including hyperbaric mepivacaine 40 mg/ml. The aim of this study was to determine the incidence of TNS after subarachnoid anaesthesia using isobaric mepivacaine 20 mg/ml and isobaric lidocaine 20 mg/ml. ⋯ In this study TNS was associated with isobaric mepivacaine 20 mg/ml, with an incidence of 7.5%, and with isobaric lidocaine 20 mg/ml, with an incidence of 2.5%, in patients having orthopaedic procedures in the supine position.
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Acta Anaesthesiol Scand · Feb 2001
Clinical TrialPerioperative response of leptin and the tumor necrosis factor alpha system in morbidly obese patients. Influence of cortisol inhibition by etomidate.
Leptin, tumor necrosis factor alpha (TNFalpha) and soluble TNFalpha receptors are secreted by the adipose tissue. Surgery induces a complex cytokine and neurohormonal response. The aim of our study was to investigate the perioperative response of leptin and the TNFalpha system in morbidly obese patients submitted to gastroplasty, and the possible involvement of cortisol in their responses. ⋯ Serum leptin and TNFalpha levels decrease in obese patients during gastroplasty. Transitory inhibition of cortisol release does not alter this response.