Acta anaesthesiologica Scandinavica
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Abstention from food and drink prior to anaesthesia remains a cornerstone in safe practice. Despite the lack of scientific support, previous guidelines, similar for fluids and solids, have for more than three decades more often than not recommended "nil by mouth" ("nothing-per-os"; "NPO" in the US) after midnight or a fixed duration of time. ⋯ Since there may be a discrepancy between conclusions based on scientific studies and the current routine practice-this presentation is intended to survey the current recommendations in different countries and how they relate to publications on the subject. Opinions are mainly derived from officers of associations linked to The World Federation for Anaesthesiologists (WFSA) and from current literature.
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Acta Anaesthesiol Scand · Sep 1996
Influence of body compartments on propofol induction dose in female patients.
For induction of anaesthesia, drugs such as propofol are commonly administered according to a per weight basis. However, drugs are primarily distributed to the fat-free mass. This study was undertaken to determine the relationship between propofol requirement for induction and body mass determined by bioimpedance analysis (BIA) or by body mass index (BMI). ⋯ Our results indicate that propofol requirements for induction are proportional to the lean body mass rather than total body weight.
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Acta Anaesthesiol Scand · Aug 1996
Randomized Controlled Trial Clinical TrialThe effects of warming intravenous fluids on intraoperative hypothermia and postoperative shivering during prolonged abdominal surgery.
The infusion of several liters of crystalloid solution at room temperature may significantly contribute to intraoperative hypothermia because warming fluid to core temperature requires body heat. The aim of this study was to evaluate the effect of delivering warmed intravenous (IV) fluid to the patient on preventing intraoperative hypothermia. ⋯ In conclusion, infusion of warmed fluids, combined with skin-surface warming, helps to prevent hypothermia and reduces the incidence of postoperative shivering.
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Acta Anaesthesiol Scand · Aug 1996
Randomized Controlled Trial Clinical TrialAnalgesic effect of intraarticular morphine. A controlled, randomised and double-blind study.
Opioids produce antinociceptive effect by acting on receptors on peripheral nerves. The clinical relevance of this effect is still debated. The aim of the study was to compare the analgesic effect of morphine intraarticularly with the intramuscular route of administration after knee surgery. ⋯ The clinical analgesic effect of 5 mg morphine given intraarticularly is equal to 5 mg morphine given intramuscularly. The occurrence of villous synovitis seems to be of no clinical importance concerning the local effect of morphine.
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Acta Anaesthesiol Scand · Aug 1996
Quantitative EEG analysis as a supplement to the clinical coma scale RLS85.
The aim of the study was to investigate the correlation between EEG indicators and clinical scores based on the RLS85 (Reaction Level Scale 85) in comatose patients. The results of a simple visual assessment of the EEG, using an arbitrary scale with typical EEG patterns, were compared with those obtained by quantitative electroencephalography (qEEG). ⋯ The amount of EEG slow activity is significantly correlated to the RLS85 score. This means that the EEG also provides information on the level and not only on the changes of the coma degree. Surprisingly, the indicators based on quantitative EEG, as used in commercially available instruments, did not give better results than the visual assessment. However, the results of the computerised analysis could be improved using multivariate statistical methods. The study also showed a way to improve communication between the neurophysiologist and clinician by presenting the EEG findings in terms similar to those used in the clinical scales. However, the clinician should be aware of the fact that the "EEG score" and the clinical score is not the same: the intention is to supplement rather than to simulate the clinical observation.