Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 1999
Case ReportsInfiltration block for caesarean section in a morbidly obese parturient.
We report a case of a morbidly obese parturient (150 kg and 150 cm) for emergency lower segment caesarean section for dead foetus. Her pregnancy had been unsupervised. ⋯ Caesarean section was performed under infiltration block using lidocaine 0.5-1.0%. Her status improved postoperatively with aggressive physiotherapy, nursing in a semirecumbent position and oxygen supplementation.
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Acta Anaesthesiol Scand · May 1999
Comparative StudyA comparison of train-of-four monitoring: mechanomyography at the thumb vs acceleromyography at the big toe.
It is not known if the information on neuromuscular function obtained from the hand is interchangeable with that of the foot. In the present study the agreement of thumb mechanomyography with acceleromyography of the big toe was studied. ⋯ We conclude that clinically acceptable agreement between thumb mechanomyography and big toe acceleromyography was found for the period of no-twitch response, suggesting that the timing of supplemental doses of vecuronium can be guided by AMG at the big toe. However, the spontaneous recovery time agreement (to TOF ratio = 0.75) between the thumb and the big toe was poor.
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The incidence of long-term post-thoracotomy pain is reported to be up to 67%. A relationship between the severity of acute postoperative pain and the development of chronic post-thoracotomy pain has been suggested. ⋯ A significant proportion of patients undergoing thoracotomies will suffer from chronic pain. Surgeons and anaesthetists should be aware of this fact and they should look for effective means of preventing and treating this pain syndrome.
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Acta Anaesthesiol Scand · May 1999
Continuous epidural administration of midazolam and bupivacaine for postoperative analgesia.
Midazolam has been reported to have a spinally mediated analgesic effect. Clinically, single-shot epidural or spinal administration of midazolam has been shown to have an analgesic effect on perioperative pain. In this study, we investigated the analgesic effect of continuous epidural administration of midazolam with bupivacaine on postoperative pain. ⋯ Adding midazolam (10 to 20 mg per 12 h) to continuous epidural infusion of bupivacaine for postoperative pain can provide a better analgesia, amnesia and sedation than bupivacaine alone.