Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 1999
ReviewOpioid use in cancer pain. Is a more liberal approach enhancing toxicity?
The majority of cancer patients develop pain before death. This pain has been shown to be underdiagnosed and undertreated. Opioid use has increased in the past 20 years in both developing and developed countries. ⋯ The syndrome of opioid-induced neurotoxicity (OIN) encompasses delirium, hallucinosis, myoclonus/seizures and hyperalgesia. Increased vigilance can lead to the timely diagnosis of OIN, and strategies for its treatment can be implemented with encouraging results. Identification and modification of risk factors for the development of OIN can help in its prevention and improve the quality of life in advanced cancer patients.
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Acta Anaesthesiol Scand · Oct 1999
Case ReportsRelief of postural post dural puncture headache by an epidural blood patch 12 months after dural puncture.
A 20-year-old previously healthy male presented at the pain clinic with chronic headache of about one year duration. Clinical examination revealed no pathological manifestations. During the consultation the patient was drinking Coca-Cola. ⋯ Postural post dural puncture headache was now suspected and an epidural blood patch performed. Despite an interval of nearly 12 months since the dural punctures, a single epidural blood patch completely relieved the headache. This case history demonstrates that an epidural blood patch should be tried if a chronic post dural puncture headache is suspected.
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Acta Anaesthesiol Scand · Sep 1999
Randomized Controlled Trial Comparative Study Clinical TrialRopivacaine in peribulbar block: a comparative study with bupivacaine.
Ropivacaine is a new local anesthetic with alleged lower systemic toxicity and slightly lower potency as compared with bupivacaine. The present study aimed to evaluate the efficacy of ropivacaine in peribulbar block, as compared with that of bupivacaine. ⋯ Both local anesthetics were effective in inducing peribulbar block for intraocular surgery. A tendency was noted to a faster onset of peribulbar block with ropivacaine; nevertheless, both drugs had a high degree of success for this block.
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Acta Anaesthesiol Scand · Sep 1999
Comparative StudyPermissive hypercapnia during thoracic anaesthesia.
While permissive hypercapnia is commonly practised in critical care, it remains unclear if the comparable manoeuvres are clinically acceptable during anaesthesia. This retrospective study aimed at describing the anaesthetic implications of hypercapnia associated with deliberate hypoventilation during thoracic surgery in patients with severe emphysema. ⋯ Although there are some limitations, this preliminary study indicates that hypercapnia around 100 mmHg during anaesthesia for thoracic surgery may not be associated with serious consequences.
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Acta Anaesthesiol Scand · Sep 1999
Case ReportsDoes use of propofol in heavy alcohol drinkers tend to discolor their urine?
A case in which the urine of a patient who was a heavy drinker turned pink when propofol was used for anesthesia is reported, and a new cause of the urine discoloration is proposed.