Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 1995
Randomized Controlled Trial Comparative Study Clinical TrialSevoflurane for ENT-surgery in children. A comparison with halothane.
Sevoflurane, a new volatile anesthetic agent, is of great potential interest in pediatric anesthesia. Its use for ENT surgery in children was compared with halothane in this study. Altogether 40 children participated in the investigation. ⋯ Initially, postoperative excitement occurred more often after sevoflurane, when paracetamol was given during anesthesia, which was reduced (P < 0.01) when paracetamol was given at the time for premedication. It is concluded that sevoflurane is an excellent induction agent, and maintains heart rate and systolic blood pressure better than when halothane is used. The incidence of cardiac arrhythmia is lower with sevoflurane than with halothane.(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · May 1995
Randomized Controlled Trial Comparative Study Clinical TrialResponse to single twitch or single burst stimulation of the ulnar nerve as predictive guide for intubating conditions.
Disappearance of response to single twitch stimulation (STS) or train-of-four stimulation (TOF) of the ulnar nerve is insufficient as predictive guide for intubating conditions during onset of non-depolarizing neuromuscular block. Double burst stimulation (DBS) appears to be a more reliable indicator of the optimal time for intubation. In the present study, the disappearance of tactile detectable response to 0.1 Hz single twitch stimulation (STS) of the ulnar nerve was compared with disappearance of response to 0.1 Hz single burst stimulation (three stimuli at 50 Hz = SBS) as predictor for optimal intubating conditions during onset of block induced by 0.08 mg.kg-1 of vecuronium in 100 patients under light general anaesthesia where thiopentone was used as the sole anaesthetic. ⋯ Intubating conditions were unacceptable in 10%, 14%, 8% and 10% of the patients in the 0.1 Hz STS, 0.1 Hz SBS, 0.05 Hz STS and 0.05 Hz SBS groups, respectively. There were no significant differences between the groups. In conclusion, neither absence of response to STS stimulation nor absence of response to SBS stimulation of the ulnar nerve at either 0.1 Hz or 0.05 Hz frequency does guarantee acceptable intubating conditions during onset of neuromuscular block induced by vecuronium 0.08 mg.kg-1 when thiopentone is used as the sole anaesthetic.
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Acta Anaesthesiol Scand · May 1995
Comparative StudyContinuous cardiac output measurements in the perioperative period.
Management of critically ill patients is based on knowledge of fundamental physiologic variables. Automatized and continuous measurement of these variables is preferable. A new system based upon the thermodilution method has been developed to measure cardiac output automatically and continuously. ⋯ In conclusion, the CCO measurement technique is a promising clinical method. The method is straightforward, requires no calibration, is independent of vascular geometry and measures with its limitations volumetric flow. Finally automatic and continuous patient monitoring provides more information and has potential to reveal previously undetected haemodynamic events.
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Acta Anaesthesiol Scand · May 1995
Case ReportsVenous blood gas analysis for evaluation of blood circulation of the hand during continuous axillary block.
Computer analysis of blood gas measurements was used to evaluate the effect of a continuous axillary block on the circulation of the hand of a patient suffering from regional circulatory insufficiency due to ligation of the brachial artery. Venous blood samples drawn from the cephalic vein were analysed at 0, 1, 2.5 and 18 hours after the blockade. Improved circulation of the hand was indicated by decreased arterio-venous oxygen difference and increased venous oxygen partial pressure following the blockade. The advantage in using the extended blood gas analysis is the possibility of estimating the main factors influencing tissue oxygenation: oxygen capacity, oxygen partial pressure and the haemoglobin oxygen affinity.
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Acta Anaesthesiol Scand · May 1995
A prospective survey of postoperative nausea and vomiting with special regard to incidence and relations to patient characteristics, anesthetic routines and surgical procedures.
We performed a prospective study on 421 patients subjected to routine general-, orthopaedic-, urologic-, gynecological and paediatric surgery to estimate the current incidences of nausea and vomiting during the first 24 hours after surgery. The overall incidences of postoperative nausea or vomiting were 17% and 28%, respectively. Postoperative emetic symptoms were not related to age in adults. ⋯ Corresponding figures for orthopaedic surgery were 25% and 34%, other kinds of extra-abdominal surgery 18% and 32% and for laparoscopy 21% and 25%. After minor gynecological-, urological- and paediatric surgery the incidences were less than 20%. In conclusion female gender, balanced anaesthesia, lengthy duration of anaesthesia, and abdominal and orthopaedic operations appeared to be most frequently associated with postoperative emetic symptoms.