Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2000
Evaluation of three risk scores to predict postoperative nausea and vomiting.
So far there are three different scores to predict postoperative vomiting (PV: Apfel et al., 1998) or postoperative nausea and vomiting (PONV: Koivuranta et al., 1997; Palazzo and Evans, 1993). All three scores used logistic regression analysis to identify and create weights for the risk factors for PV or PONV. In short, these were sex, age, history of previous PONV, motion sickness, duration of anaesthesia, and use of postoperative opioids. However, an external evaluation and a comparison of these scores has not been performed so far. ⋯ The occurrence of PV and PONV in patients undergoing surgery under balanced anaesthesia can be predicted with moderate but acceptable accuracy using one of the available risk scores, regardless of local surgical or anaesthesiological circumstances. For clinical practice, we recommend the score published by Koivuranta, since its calculation is very simple.
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Acta Anaesthesiol Scand · Apr 2000
A catheter technique in ophthalmic regional anaesthesia. Cadaver experiments.
Regional anaesthesia for ophthalmic surgery is generally accomplished by peri- or retrobulbar techniques. Depending on the duration of ophthalmic surgery, reblock might become necessary. Our goal was to invent a catheter technique for ophthalmic regional anaesthesia that enables the user to administer local anaesthetics intraoperatively into the peri- or retrobulbar space continuously. ⋯ Examining the spread of the dye in the orbit, we concluded that it is possible to provide ophthalmic anaesthesia for surgery through an indwelling catheter. We proved that continuous or intermittent administration of a local anaesthetic agent into the extra- or inraconal space can be achieved and this technique may allow us to maintain anaesthesia as long as it is necessary.
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Acta Anaesthesiol Scand · Apr 2000
Intermittent capnography during high-frequency jet ventilation for prolonged rigid bronchoscopy.
Gas exchange during high-frequency jet ventilation (HFJV) for prolonged rigid bronchoscopy (RBS) is usually monitored by arterial blood gas analysis. Capnography of expired gases during brief HFJV discontinuation may be a reliable and noninvasive supplemental method. Capnography can be performed either for single breaths or with respiratory rate (RR) reduced to 10 x min(-1). The aim of this study was to demonstrate that capnography during short periods of HFJV discontinuation represents a reliable measure of PaCO2 during prolonged RBS. ⋯ Capnography performed during short periods of HFJV discontinuation reliably and noninvasively reflects PaCO2 during prolonged endoscopic procedures. Capnography during HFJV for RBS may reduce the frequency of arterial blood gas sampling, the duration of unmonitored intervals and costs.
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Acta Anaesthesiol Scand · Apr 2000
Tubeless combined high-frequency jet ventilation for laryngotracheal laser surgery in paediatric anaesthesia.
High-frequency jet ventilation (HFJV) is an alternative ventilatory approach in airway surgery and for facilitating gas exchange in patients with pulmonary insufficiency. We have developed a new technique of combined HFJV utilising two superimposed jet streams. In this study we describe the application of tubeless supralaryngeal HFJV during laryngotracheal laser surgery in infants and children. ⋯ The application of the combined double frequency HFJV was effective in maintaining gas exchange in the presence of laryngeal or tracheal stenoses. It provided good visibility of anatomical structures and offered space for surgical manipulation, avoiding the use of combustible material inside the larynx or trachea.
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Acta Anaesthesiol Scand · Apr 2000
A catheter technique in ophthalmic regional anaesthesia. Clinical investigations.
Usually general anaesthesia is chosen if ophthalmic surgery of longer duration is expected. Our goal was to introduce a flexible catheter preoperatively into the extra- or intraconal space and to provide sufficient anaesthesia by continuous administration of a local anaesthetic via the catheter. ⋯ Continuous administration of a local anaesthetic agent via an indwelling catheter into the intraconal space allowed ophthalmic anaesthesia without time restriction. Thus, CRA is a good alternative to general anaesthesia for patients undergoing long-lasting ophthalmic surgery.