Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 1997
Case ReportsIncidence of awareness in total i.v. anaesthesia based on propofol, alfentanil and neuromuscular blockade.
There is no reliable technique for monitoring drug concentrations in total i.v. anaesthesia (TIVA) with muscle relaxation. An increased risk of awareness with TIVA has been stated as a possible drawback. The present study was conducted in order to assess the incidence of conscious awareness in TIVA based on propofol, alfentanil and neuromuscular blockade. ⋯ If the true incidence of conscious awareness is to be determined, interviews must be extended beyond the first postoperative day. Our study indicates that if appropriate dosing of propofol and alfentanil are adhered to, and proper action is taken in case of haemodynamic alterations suggestive of inadequate anaesthesia, the incidence of conscious awareness in non-cardiac TIVA with neuromuscular blockade is low.
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Acta Anaesthesiol Scand · Sep 1997
Case ReportsManagement of the difficult airway. A case of failed fiberoptic intubation.
Fiberoptic intubation is the current gold standard for the management of difficult intubation. Nevertheless, in rare circumstances even fiberoptic intubation fails. ⋯ This case illustrates that even awake fiberoptic intubation has its failure rate, due to inability to visualize the larynx, inability to advance the tube over the fiberscope (as in the present case), or inability to direct the tube towards the larynx. Due to the extreme deviation of the larynx other established techniques for difficult intubation were not deemed appropriate in this case. Therefore, weighing the risks and benefits, a decision was made to perform a tracheotomy under local anaesthesia.
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Acta Anaesthesiol Scand · Sep 1997
Case ReportsAnaphylactic shock following intravenous administration of lignocaine.
A 26-year-old female, presenting for dental surgery, developed anaphylactic shock immediately after intravenous administration of lignocaine without preservative added to the propofol to alleviate pain during intravenous injection. We describe the clinical circumstances, the management and the investigations carried out to detect the cause.
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Acta Anaesthesiol Scand · Sep 1997
Cerebral normoxia in the rhesus monkey during isoflurane- or propofol-induced hypotension and hypocapnia, despite disparate blood-flow patterns. A positron emission tomography study.
Due to a few reports of cerebral dysfunction in connection with isoflurane-induced hypotension and concomitant hypocapnia, positron emission tomography (PET) was used to measure cerebral oxygenation and blood flow during similar conditions with isoflurane or propofol. ⋯ PET indicated adequate cerebral oxygenation during isoflurane and propofol anaesthesia, despite disparate blood-flow patterns. Hypotension and concomitant moderate hyperventilation reduced rCBF, but did not result in hypoxia.
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Acta Anaesthesiol Scand · Sep 1997
Randomized Controlled Trial Clinical TrialPerioperative magnesium infusion and postoperative pain.
NMDA receptor activation is considered one of the mechanisms involved in postoperative pain and hypersensitivity. Magnesium is the physiological blocker of the NMDA-receptor-complex-associated calcium ionophore. The aim of this study was to determine if a pre-, intra- and postoperative infusion of magnesium would reduce postoperative pain. ⋯ Perioperative magnesium infusion does not improve postoperative analgesia. At the doses used in this study, the use of magnesium is associated with short-term decreases in postoperative analgesia.