Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2000
Randomized Controlled Trial Comparative Study Clinical TrialThe incidence of transient neurologic symptoms (TNS) after spinal anaesthesia in patients undergoing surgery in the supine position. Hyperbaric lidocaine 5% versus hyperbaric bupivacaine 0.5%.
The incidence of TNS after spinal anaesthesia is a problem. Especially the use of hyperbaric lidocaine in patients placed in the lithotomy position during surgery has been associated with a high incidence of TNS. The present study was performed to investigate whether TNS is present more frequently in patients undergoing surgery in the supine position with use of hyperbaric lidocaine compared with hyperbaric bupivacaine. ⋯ TNS is a significant problem in patients having spinal anaesthesia with hyperbaric lidocaine compared to hyperbaric bupivacaine, both in the supine position. For day-case surgery, TNS would start after dismissal from hospital. The use of hyperbaric lidocaine is therefore questionable, even though these problems are of an order that the majority of patients would still choose spinal anaesthesia for future operations.
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Acta Anaesthesiol Scand · Feb 2000
Auditory evoked responses and learning and awareness during general anesthesia.
There is a major distinction between conscious and unconscious learning. Monitoring the mid-latency auditory evoked responses (AER) has been proposed as a measure to ascertain the adequacy of the hypnotic state during surgery. In the present study, we investigated the presence of explicit and implicit memories after anesthesia and examined the relationships of such memories to the AER. ⋯ The incidence of awareness in patients anesthetized with nitrous oxide and bolus supplementation was 6%. Thus, this anesthetic technique did not reduce the risk of awareness compared with the use of nitrous oxide alone. Implicit memory occurred during nitrous oxide and bolus supplementation. Recording AER during anesthesia may help to predict awareness and implicit memory, particularly the former. The short contents of most of the dreams which were recalled could hamper future studies in this area.
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Acta Anaesthesiol Scand · Feb 2000
Randomized Controlled Trial Clinical TrialHaemodynamic effects of intravenous clonidine on propofol or thiopental induction.
The study evaluated the effects of premedication with intravenous clonidine on thiopental or propofol requirements for induction and haemodynamic changes associated with both induction and endotracheal intubation. Clonidine administered intravenously before induction of anaesthesia reduced propofol or thiopental requirements. ⋯ Moreover, a major haemodynamic stability was registered before and after laryngoscopy in the clonidine-thiopental group. These findings might contraindicate the clonidine-propofol combination in patients with cardiovascular disease.
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Acta Anaesthesiol Scand · Feb 2000
Randomized Controlled Trial Comparative Study Clinical TrialCost comparison between three different general anaesthetic techniques for elective arthroscopy of the knee.
We compared three anaesthetic techniques for elective knee arthroscopy with special reference to cost-effectiveness. ⋯ From a cost-minimisation point of view, anaesthesia based on sevoflurane in oxygen:nitrous oxide is the technique of choice.
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Acta Anaesthesiol Scand · Feb 2000
Influence of acute normovolaemic haemodilution on the dose-response and time-course of action of atracurium.
Acute normovolaemic haemodilution is a common method to save and avoid homologous blood transfusion during surgery. The aim of this study was to evaluate the influence of acute isovolaemic haemodilution on the dose-response and time-course of action of atracurium. ⋯ We concluded that the patients undergoing acute isovolaemic haemodilution were about 30% more sensitive to neuromuscular blockade of atracurium and had a longer duration after administration of the same dose (microg/kg) than the control patients. Care must be taken with this problem when atracurium is used as a muscle relaxant during acute haemodilution.