Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Mar 2000
Contractures in skeletal muscle of malignant hyperthermia susceptible patients after in vitro exposure to sevoflurane.
Sevoflurane, a potent inhalational anaesthetic agent that is structurally similar to halothane, has some favourable characteristics, but may also be able to trigger malignant hyperthermia (MH) in susceptible patients. The diagnosis of malignant hyperthermia susceptibility relies on the in vitro contracture test on skeletal muscle. The present study was undertaken to investigate whether exposure to sevoflurane of muscles of malignant hyperthermia susceptible (MHS) patients would also cause an abnormal contracture. ⋯ Sevoflurane can trigger an abnormal contracture in human muscle in vitro. This is indicative of malignant hyperthermia susceptibility. Exposure to sevoflurane should be avoided in patients thought to be susceptible to malignant hyperthermia.
-
Acta Anaesthesiol Scand · Mar 2000
Comparative StudyLung lymph response to overinfusion with hydroxyethyl starch in sheep. Comparative studies of high and low molecular weight compounds.
Several hydroxyethyl starch (HES) solutions are available clinically. We performed comparative studies of low and high molecular weight HES to evaluate the effects on lung lymph flow in sheep, to see the difference in the types of HES. ⋯ These data suggest that low molecular HES is as useful a plasma substitute as high molecular HES, but may increase lung fluid filtration in the overinfused state.
-
Acta Anaesthesiol Scand · Mar 2000
Midlatency median nerve evoked responses during recovery from propofol/sufentanil total intravenous anaesthesia.
Median nerve somatosensory evoked responses (MnSSER) are frequently used to monitor the integrity of the somatosensory pathway during surgery. We investigated MnSSER components during the wakeup phase from anaesthesia with propofol/sufentanil, because detailed information is lacking about the reversibility of anaesthetic induced changes of MnSSER. The aim of the study was to document precisely the MnSSER waves in relation to the clinical awakening. The hypothesis was that anaesthetic induced MnSSER changes are reversed when the patient becomes responsive after anaesthesia. ⋯ Persistent changes of MnSSER waves > or =35 ms reflect impaired signal processing along the somatosensory pathway following propofol/sufentanil anaesthesia when the patients are responsive again. Further studies combining MnSSER recording with distinct neuro-psychological tests are needed to define the clinical relevance of these findings.
-
Acta Anaesthesiol Scand · Mar 2000
Estimation of cardiac preload changes by systolic pressure variation in pigs undergoing pneumoperitoneum.
Variations in systolic pressure arterial waveform (SPV) and its component have been shown to be a reasonable indicator of left ventricular preload. Creation of a pneumoperitoneum (PMOP) by insufflation of CO2 increases intrathoracic pressure, leading to overestimation of preload as assessed by pressure methods. The purpose of this study was to compare SPV with other standard methods in anaesthetized pigs. ⋯ In anaesthetized pigs, the creation of a PMOP alters SPV, likely by decreasing lung compliance. Once PMOP is established, changes in cardiac preload could be estimated by SPV analysis.
-
Acta Anaesthesiol Scand · Mar 2000
Postoperative pain control by epidural analgesia after transabdominal surgery. Efficacy and problems encountered in daily routine.
The efficacy of postoperative epidural pain treatment has been well documented in controlled studies. However, the literature concerning results of daily routine use of this method often only emphasises certain aspects of it. ⋯ Analgesia was insufficient when coughing and moving in an unacceptably large number of the patients. Also the number of epidural catheter related problems was high. In order to make early intervention possible, the patients and epidural catheters should be observed daily and systematically by members of the staff competent to detect possible problems.