Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 1994
Randomized Controlled Trial Clinical TrialThe agreement between adductor pollicis mechanomyogram and first dorsal interosseous electromyogram. A pharmacodynamic study of rocuronium and vecuronium.
The agreement between evoked adductor pollicis mechanomyogram and first dorsal interosseous evoked electromyogram (EMG) was evaluated during a pharmacodynamic study of rocuronium and vecuronium. In the first place the effective doses of rocuronium producing 50% and 90% block (ED50 and ED90, respectively) were established in 32 neurolept anaesthetized patients from the adductor pollicis mechanomyogram and the first dorsal interosseous EMG area and amplitude. Secondly, limits of agreement between the two methods were evaluated from the mean difference between methods +/- 2 s.d. in 20 patients during onset of block following 2 x ED90 of rocuronium and vecuronium, and during recovery from the last supplementary dose of 1/2 x ED90. ⋯ Agreement between the amplitude and the area of the EMG were better than between the mechanomyogram and the EMG. Evaluation of the time courses of action showed that rocuronium had a faster onset of action than vecuronium (1.8 min compared to 2.8 min) while duration of action and reversal were similar. In conclusion, the first dorsal interosseous EMG amplitude and area can be used to assess rocuronium and vecuronium block.
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Acta Anaesthesiol Scand · Nov 1994
Acid aspiration syndrome prophylaxis in gynaecological and obstetric patients. A Norwegian survey.
Clinical practice and attitudes of Acid Aspiration Syndrome (AAS) prevention in connection with gynaecological and obstetric surgery were surveyed in all Norwegian departments of anaesthesia. General anaesthesia with rapid-sequence intubation using succinylcholine and cricoid pressure was the preferred method for all emergency surgery, except Caesarian section (C-section) where 58% of the departments reported use of spinal or epidural anaesthesia if time allowed for its use. ⋯ While all responders considered recent intake of a "light breakfast" in an elective patient to be a risk factor of AAS indicating delay of surgery or use of specific precautions like regional anaesthesia, rapid-sequence intubation, or chemoprophylaxis, 52-72% of the responders considered obesity, dyspepsia, recent water intake, smoking or use of chewing gum to be risk factors as well. We think this survey demonstrates a need for consensus discussions of AAS prophylaxis.
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Acta Anaesthesiol Scand · Nov 1994
Randomized Controlled Trial Comparative Study Clinical TrialIntradermal anaesthesia: comparison of several compounds.
To compare the efficacy of different local anaesthetics to produce intradermal anaesthesia for venous cannulation and the discomfort associated with skin infiltration. ⋯ Of the local anaesthetics tested, Mepivacaine-1 is the drug of choice for skin infiltration as its injection elicits least discomfort.
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Acta Anaesthesiol Scand · Nov 1994
Randomized Controlled Trial Clinical TrialPlatelet activation in major surgical stress: influence of combined epidural and general anaesthesia.
Platelets are activated in surgery releasing vasoactive substances such as serotonin and thromboxane. Platelets become temporarily hypoaggregable during surgery followed by a postoperative hyperaggregability. Local anaesthetics are known to inhibit platelet function but earlier reports are conflicting. ⋯ Postoperatively both groups showed significant hyperaggregability. The release products were not significantly influenced by regional anaesthesia. In conclusion epidural as combined with general anaesthesia affects platelet responses to major abdominal surgery only to a minor extent, although it may attenuate the haemodynamic response.