Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Oct 2000
Case ReportsHemidiaphragmatic paresis after interscalene supplementation of insufficient axillary block with 3 mL of 2% mepivacaine.
Breathing difficulty, agitation, and confusion developed in a 55-year-old male, ASA classification group III with a non-small-cell lung cancer 10 min after interscalene supplementation of insufficient axillary block with 3 mL of 2% mepivacaine with adrenaline 5 microg mL(-1). After administration of thiopentone and suxamethonium the patient's trachea was intubated and the lungs were ventilated with oxygen-enriched air. ⋯ Postoperatively, the patient was somnolent and hypercapnic, but maintained satisfactory oxygenation while breathing spontaneously and was extubated. Both the temporal relationship of events and the regression of all symptoms within three hours suggest that 3 mL of mepivacaine with adrenaline injected into the interscalene space blocked the phrenic nerve and compromised diaphragmatic function, which precipitated the respiratory failure.
-
Acta Anaesthesiol Scand · Oct 2000
Randomized Controlled Trial Clinical TrialEpidural infusion of bupivacaine and fentanyl reduces perioperative myocardial ischaemia in elderly patients with hip fracture--a randomized controlled trial.
Perioperative myocardial ischaemia is an important risk factor for cardiac morbidity and mortality after noncardiac surgery. The impact of analgesic management on the incidence and severity of cardiac ischemia was studied in 77 elderly patients undergoing surgical treatment of traumatic hip fracture. ⋯ Continuous epidural bupivacaine/fentanyl analgesic regimen, started preoperatively, reduces the amount of myocardial ischaemia in elderly patients with hip fracture.
-
Acta Anaesthesiol Scand · Oct 2000
Randomized Controlled Trial Clinical TrialEfficacy of intrathecal neostigmine for the relief of postinguinal hemiorrhaphy pain.
Intrathecal administration of various doses of neostigmine has been reported to produce analgesia without neurotoxicity in both animal and human studies. The present study was undertaken to evaluate the efficacy and safety of intrathecal neostigmine for the relief of pain for patients having undergone inguinal herniorrhaphy surgery. ⋯ Our study showed that intrathecal neostigmine at 50 pg or 100 microg enhanced the onset of tetracaine anaesthesia and provided analgesia lasting for 6-9 h, although increased incidences of prolonged motor blockade and nausea or vomiting were noted.
-
Acta Anaesthesiol Scand · Oct 2000
Randomized Controlled Trial Clinical TrialPreoperative ropivacaine infiltration in breast surgery.
The aim of the study was to investigate whether preoperative infiltration with ropivacaine in conjunction with breast surgery improves postoperative pain management and attenuates postoperative nausea and vomiting. ⋯ We found no differences in postoperative pain management between 3.75 mg/ml ropivacaine and saline wound infiltration before breast surgery. The data show similar postoperative needs of analgesics and antiemetics with a similar frequency of PONV.
-
Acta Anaesthesiol Scand · Oct 2000
Randomized Controlled Trial Clinical TrialElectrical stimulation of the vestibular system prevents postoperative nausea and vomiting.
Electrical stimulation of the vestibular system may prevent nausea and vomiting. We studied the influence of transcutaneous impulse stimulation in prevention of postoperative nausea and vomiting (PONV) following gynaecological surgery. ⋯ This study suggests that electrical stimulation of the vestibular system may be useful in prevention of PONV.