Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 2000
Randomized Controlled Trial Clinical TrialPreoperative treatment with recombinant human erythropoietin or predeposit of autologous blood in women undergoing primary hip replacement.
Controversy exists about the advantages of predeposit of autologous blood (PDAB), and whether more comfortable blood conservation regimens may yield comparable results. To test the hypothesis that preoperative treatment with recombinant human erythropoietin (rHuEPO) with or without acute concomitant normovolaemic haemodilution (ANHD) is as effective as PDAB in reducing allogeneic blood transfusions, we conducted a prospective randomised study in women undergoing primary hip replacement. ⋯ Withdrawal of autologous blood is associated with lower pre- and intraoperative haemoglobin levels when compared to preoperative augmentation of red cell mass using rHu-EPO. As a measure to reduce allogeneic transfusion requirements, preoperative treatment with rHuEPO may be as effective as standard predeposit of autologous blood in women undergoing primary hip replacement, but requires less preoperative time.
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Acta Anaesthesiol Scand · Jul 2000
Randomized Controlled Trial Meta Analysis Comparative Study Clinical TrialPostural post-dural puncture headache. A prospective randomised study and a meta-analysis comparing two different 0.40 mm O.D. (27 g) spinal needles.
To compare the incidence of postural post-dural puncture headache (PPDPH) after spinal anaesthesia using two different 0.40 mm O.D. (27 g) spinal needles: pencil-point needle and Quincke needle. In addition, a meta-analysis of studies comparing small bore spinal needles with regard to development of PPDPH was performed. ⋯ A pencil-point-shaped spinal needle will significantly reduce PPDPH compared with Quincke-type spinal needles, also when small bore needles (0.40 mm O.D.) are used.
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Acta Anaesthesiol Scand · Jul 2000
ReviewLocal infiltration with NSAIDs for postoperative analgesia: evidence for a peripheral analgesic action.
In order to investigate the evidence for a peripheral analgesic effect of local infiltration with nonsteroidal antiinflammatory drugs (NSAIDs) in postoperative pain, we conducted a systematic review. ⋯ There is evidence for a clinically relevant peripheral analgesic action of intra-articular NSAIDs while results of IVRA and wound infiltration with NSAIDs in postoperative pain are inconclusive. Trials without a systemic control group were not considered to provide evidence for a local effect.
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Acta Anaesthesiol Scand · Jul 2000
Randomized Controlled Trial Clinical TrialEpileptiform EEG during sevoflurane mask induction: effect of delaying the onset of hyperventilation.
Hyperventilation during sevoflurane-N2O-O2 mask induction in adults is associated with a hyperdynamic circulatory response and epileptiform electroencephalogram (EEG). We tested the hypothesis that delaying onset of hyperventilation will prevent severe (periodic) epileptiform EEG and hyperdynamic response. ⋯ Regardless of its timing, hyperventilation at a high sevoflurane concentration produced severe epileptiform EEG with a hyperdynamic response. PED tended to occur more often with immediate onset of hyperventilation.
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Acta Anaesthesiol Scand · Jul 2000
Randomized Controlled Trial Clinical TrialEsmolol cardioplegia in unstable coronary revascularisation patients. A randomised clinical trial.
Esmolol has been studied and applied to control hypertension and tachycardia during open heart surgery. Esmolol has been used on a minor scale as a single cardioplegic agent. Little information is available on esmolol as a component of blood cardioplegia. In this prospective, randomised, double-blind clinical study we investigated whether esmolol improves cardioprotection in patients scheduled for an urgent coronary operation. ⋯ Esmolol addition to blood cardioplegia did not increase the efficacy of cardioprotection in the present study setting in unstable patients during urgent coronary revascularisation.