Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2000
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of coracoid and axillary approaches to the brachial plexus.
Brachial plexus block by the coracoid approach does not require arm abduction and may be more effective than the axillary approach because of a more proximal injection of local anaesthetic. However, the clinical usefulness of the coracoid approach has not been tested in prospective controlled trials. The present randomized, observer-blinded study compared success rates, time to obtain a complete block, frequency of adverse effects and block discomfort in two groups of 30 patients, anaesthetized for hand surgery using either the coracoid or the axillary approach to the brachial plexus. ⋯ The axillary approach to the brachial plexus using four injections of ropivacaine results in a faster onset of block and a better spread of analgesia than the coracoid approach using two injections.
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Acta Anaesthesiol Scand · Mar 2000
Randomized Controlled Trial Comparative Study Clinical TrialCore and thenar skin temperature variation during prolonged abdominal surgery: comparison of two sites of active forced air warming.
This study was designed to compare the efficacy of two different sites of active forced air warming, upper body or lower body, to maintain normothermia; and their respective effect on thenar skin temperature in relation to the accelerographic monitoring of neuromuscular blockade during long-lasting abdominal surgery. ⋯ This study suggests that during long-lasting abdominal surgery, normothermia is maintained after 2-3 h by either upper or lower body active forced air warming. After an initial post-induction mild hypothermia, normothermia was achieved faster with lower body surface warming. Thenar skin temperature trend showed that it remained above 32 degrees C during most of the procedure in both groups.
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Acta Anaesthesiol Scand · Mar 2000
High-dose rectal and oral acetaminophen in postoperative patients--serum and saliva concentrations.
The primary purpose of the study was to examine the absorption of acetaminophen by measuring serum and saliva concentrations produced by a standard postoperative acetaminophen dosing regimen and secondary to examine the correlation between saliva and serum concentrations of acetaminophen after rectal and oral dosing. ⋯ The slow and ongoing absorption process resulting in no maximum concentration within 4 h after administration of 2000 mg acetaminophen suppositories makes this rectal regimen therapeutically irrational for treatment of postoperative pain. The significant ratio and linear correlation between saliva and serum concentrations of acetaminophen suggests that saliva could be used instead of blood to monitor acetaminophen administration in patients.
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Acta Anaesthesiol Scand · Mar 2000
Randomized Controlled Trial Clinical TrialIntraperitoneal lidocaine for postoperative pain after laparoscopy.
A controversy exists over the effectiveness and clinical value of intraperitoneal local anaesthetics for treating pain after laparoscopic cholecystectomy. The use of intraperitoneal lidocaine was evaluated in this study. ⋯ Intraperitoneal lidocaine is simple to use and results in a long-lasting reduction of pain after a single administration.
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Acta Anaesthesiol Scand · Mar 2000
Case ReportsSevoflurane as a sole anaesthetic for thymectomy in myasthenia gravis.
Myasthenia gravis is a challenging situation for anaesthesiologists due to its neuromuscular involvement. The main concerns are respiratory muscle weakness and side effects due to a heavy dose of anticholinesterases. This limits the use of sedatives, hypnotics and muscle relaxants. ⋯ Sevoflurane in oxygen and nitrous oxide (MAC=0.5-0.7) was used for maintenance of anaesthesia. Recovery was smooth and fast with no residual respiratory insufficiency. Hence we found sevoflurane to be a highly suitable agent for thymectomy in mysthenia gravis.