Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2000
Pulsatility does not change cerebral oxygenation during cardiopulmonary bypass.
To determine the effect of pulsatility during cardiopulmonary bypass (CPB) on cerebral oxygenation, we measured oxyhaemoglobin (HbO2), deoxyhaemoglobin (Hb) and oxidised cytochrome aa3 (CtO2) with near-infrared spectroscopy (NIRS) in 14 patients electively scheduled for cardiac surgery. ⋯ Neither oxygenated haemoglobin, nor intracellular oxygenation, represented by CtO2, indicated a beneficial effect of pulsatile perfusion during hypothermic CPB. These results, however, are only valid for short time effects within 10 min before rewarming from CPB and patients without flow-limiting stenoses of the carotid artery.
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Acta Anaesthesiol Scand · May 2000
A new method for non-invasive, manoeuvre-free determination of "static" pressure-volume curves during dynamic/therapeutic mechanical ventilation.
Lung mechanics are usually measured using static or quasistatic methods, abandoning normal ventilatory treatment. We have developed a method to calculate the alveolar pressure during dynamic/therapeutic conditions, "the dynostatic pressure" (P(dyn)), using airway pressure (P) measured in the trachea and volume (V) and flow (V) at the Y-piece. ⋯ The dynostatic method gives a breath-by-breath reflection of the interaction between ventilatory settings and lung mechanics in patients during ordinary ventilator treatment. It is only marginally affected by the moderate differences in inspiratory versus expiratory resistances present in patients with ALI.
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Acta Anaesthesiol Scand · May 2000
Movement of the endotracheal tube during laparoscopic hernia repair.
Laparoscopic surgery is not without its problems, and one of the less known is cephalad displacement of the carina and relative movement of the endotracheal tube in the trachea. The aetiology of this is presumably a consequence of both pneumoperitoneum and the Trendelenburg position frequently adopted during laparoscopic surgery. ⋯ We conclude that the endotracheal tube does not routinely migrate towards the carina when laparoscopic hernia repair is performed under these conditions.
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Acta Anaesthesiol Scand · May 2000
Effects of vecuronium and rocuronium in antagonistic laryngeal muscles and the anterior tibial muscle in the cat.
Adequate vocal cord paralysis and full recovery of laryngeal muscle function are important when muscle relaxants are used perioperatively. This study was designed to compare the effects of vecuronium and rocuronium at the vocal cord abductor and adductor muscles and the anterior tibial muscle in cats. ⋯ In cats, the time course of neuromuscular blockade after vecuronium and rocuronium differs in antagonistic laryngeal muscles. The protective laryngeal function of glottis closure recovers later than vocal cord abduction after both vecuronium and rocuronium.
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Acta Anaesthesiol Scand · Apr 2000
Randomized Controlled Trial Clinical TrialRopivacaine-clonidine combination for caudal blockade in children.
Adding clonidine to weak ropivacaine solutions (<0.2%) could potentially enhance analgesia as well as further reduce the risk for unwanted motor blockade. The aim of the present study was to compare the postoperative pain-relieving quality of a ropivacaine 0.1%-clonidine mixture to that of plain ropivacaine 0.2% following caudal administration in children. ⋯ The combination of clonidine (2 microg/kg) and ropivacaine 0.1% is associated with an improved quality of postoperative analgesia compared to plain 0.2% ropivacaine. The improved analgesic quality of the clonidine-ropivacaine mixture is achieved without causing any significant degree of postoperative sedation.