Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jun 1997
Randomized Controlled Trial Clinical TrialGrading of severity of postdural puncture headache after 27-gauge Quincke and Whitacre needles.
Small-gauge needles are reported to have a low incidence of complications. Pencil-point needles are associated with a lower frequency of postdural puncture headache (PDPH), but a higher failure rate than Quincke needles. ⋯ We conclude that the 27-gauge Whitacre needle is the 'needle of choice' in patients with normal body stature. The incidence of PDPH following Quincke needles may not only be affected by the direction of the bevel during insertion but also during removal. Statistically, there was no gender variation in PDPH in this study (P = 0.5). A previous history of recurrent headache or migraine does not predispose to PDPH.
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Acta Anaesthesiol Scand · Jun 1997
Randomized Controlled Trial Clinical Trial2-Chloroprocaine antagonism of epidural morphine analgesia.
2-Chloroprocaine (2-CP) used for lumbar epidural anesthesia (LEA) reportedly decreases the efficacy of epidural morphine (EM) administered for post-cesarean section (CS) analgesia. The amount of supplemental i.v. morphine self-administered by the patient via the patient-controlled analgesia device (PCA) is used to study the interaction between EM and 2-CP. ⋯ Analgesic efficacy of EM is decreased when 2-CP is used for LEA compared to when Lido + Epi is used.
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Acta Anaesthesiol Scand · Jun 1997
Mivazerol, a new alpha 2-adrenergic agonist, blunts cardiovascular effects following surgical stress in pentobarbital-anesthetized rats.
Mivazerol is a new and selective alpha 2-adrenoceptor agonist, devoid of hypotensive effects, which has been designed to prevent adverse cardiac outcome in perioperative patients with, or at risk coronary artery disease. ⋯ Mivazerol attenuates surgical stress-induced elevations in BP and HR during pentobarbital anesthesia in rats, and these effects are mediated by stimulation of alpha 2-adrenoceptors. Unlike dexmedetomidine, mivazerol does not reduce BP, and is also more potent than dexmedetomidine in blunting surgical stress-induced increases in BP in pentobarbital-anesthetized rats.
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Acta Anaesthesiol Scand · Jun 1997
Delayed derecruitment after removal of PEEP in patients with acute lung injury.
A step decrease in positive end-expiratory airway pressure (PEEP) is not followed by an instantaneous loss of the PEEP-induced increase in end-expiratory lung volume (EELV). Rather, the reduction of EELV is delayed, while adverse PEEP effects on hemodynamics are immediately attenuated upon the drop in airway pressure. Step PEEP increments were applied to the lungs of patients with acute lung injury. It was investigated retrospectively whether enlargement of end-expiratory lung volume and changes in lung mechanics persist 45 min after removal of the PEEP increment. ⋯ A subgroup of patients with acute lung injury, the characteristics of which remain to be defined, benefit from prolonged recruitment effects up to 45 min after removal of a PEEP increment, while sequelae of continuously increased airway pressures are minimised.
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Acta Anaesthesiol Scand · Jun 1997
Impedance cardiography in cardiac surgery patients: abnormal body weight gives unreliable cardiac output measurements.
To study the accuracy of cardiac output measurement by means of Electrical Impedance Cardiography (EIC) in post-cardiac surgery patients. ⋯ The results of this study indicate that weight is a very important factor in unreliable measurement of CO by impedance cardiography in cardiac surgery patients. The calculation equation as proposed by Sramek and Bernstein is not accurate enough in patients with more than 15% of weight deviation. Therefore, the use of impedance cardiography in these patients is of limited value until an accurate correction factor has been developed.