Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 1998
1 MAC-incision sevoflurane prevents explicit awareness during surgical skin incision and tracheal intubation.
This study tested the hypothesis that 1 MAC-incision anesthesia secures unconsciousness during surgical skin incision and tracheal intubation. ⋯ It is concluded that 1MAC-incision sevoflurane secures unconsciousness during surgical skin incision and tracheal intubation.
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Acta Anaesthesiol Scand · Nov 1998
Forward blood flow during cardiopulmonary resuscitation in patients with severe accidental hypothermia. An echocardiographic study.
The mechanism responsible for the forward blood flow associated with external chest compression is still controversial. Evidence for both blood flow caused by direct cardiac compression and blood flow generated by a general increase in intrathoracic pressure has been found in experimental as well as clinical studies. No data are available concerning the mechanism causing forward blood flow in hypothermic patients undergoing cardiopulmonary resuscitation. Therefore, echocardiographic findings during external chest compression in seven hypothermic arrest victims are reported. ⋯ In contrast to normothermic arrest victims, an open mitral valve during external chest compression is a common finding during hypothermia, indicating that thoracic pump mechanism is important for forward blood flow during cardiopulmonary resuscitation in hypothermic arrest victims. Aortic valve opening in two hypothermic arrest victims suggests forward blood flow also during active decompression of the thorax with the Cardiopump.
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Acta Anaesthesiol Scand · Nov 1998
Changing preoperative fasting policies. Impact of a national consensus.
Liberalisation of preoperative fasting rules has been discussed and recommended in the anaesthesia literature in recent years. In Norway, a national consensus on this issue was reached in 1993. The aim of the present study was to investigate whether a national consensus on fasting recommendations led to a change in fasting policies in Norwegian anaesthesia departments. ⋯ The new, consensus-based national fasting guidelines have been associated with a change towards more liberal fasting policies in Norwegian departments of anaesthesia. However, as not all local changes were supported by the national consensus, other sources of information were used when local policies were decided.
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Acta Anaesthesiol Scand · Nov 1998
Randomized Controlled Trial Comparative Study Clinical TrialSubarachnoid and intravenous PCA versus bolus administration for postoperative pain relief in orthopaedic patients.
Patient-controlled analgesia (PCA) with intravenous piritramide and subarachnoid bupivacaine was studied during postoperative pain management in comparison with nurse-administered bolus injections. ⋯ PCA with CSA was more effective than nurse-administered bolus-administration of bupivacaine, while the present study failed to show superiority of i.v. PCA over i.v. bolus-administration of piritramide. PCA using the subarachnoid route is a promising concept for treatment of postoperative pain in orthopaedic patients, while the PCA piritramide regime of this study warrants improvement.
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Acta Anaesthesiol Scand · Nov 1998
Case ReportsCatheter-induced thrombus in the superior vena cava diagnosed by transesophageal echocardiography.
To present the role of transesophageal echocardiography (TEE) in the diagnosis and management of catheter-related superior vena cava thrombosis. ⋯ In a case of catheter-induced superior vena cava thrombosis with septicemia and pulmonary embolism, bedside TEE was very helpful to make the correct diagnosis early, assess thrombus size during anticoagulation, and monitor cardiac performance and thrombus disposition during central venous catheter removal.