Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 1996
Comparative Study Clinical Trial Controlled Clinical TrialA comparison of the laryngeal mask and tracheal tube for controlled ventilation.
The use of laryngeal mask airway (LMA), size 3 or 4, and endotracheal tube (ETT) 8.0 mm was studied comparatively to determine the adequacy of respiratory function during positive pressure ventilation (PPV) by applying a series of given peak inspiratory pressures (PIPs) of 10.0, 12.5, 15.0, 17.5, 20.0 and 30.0 cm H2O. Eleven anesthetised patients underwent a double comparative trial. ⋯ Higher values of VT (1.7 mk.kg-1) were expired via the LMA compared with ETT when a given PIP of less than 20 cmH2O was applied. LMA as opposed to ETT secured normocapnia during PPV with low PIPs.
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Acta Anaesthesiol Belg · Jan 1996
Comparative StudyComparison between CDI-100 continuous SO2, Hb, and Hct monitoring, intermittent ABL-4 saturation and Hb monitoring, and lab Hb and Hct monitoring.
During extracorporeal circulation (ECC) a continuous monitoring of venous oxygen saturation yields a quantitative impression of the equilibrium of oxygen supply and oxygen consumption in steady state conditions. The aim of the investigation was to study whether the measurements of venous oxygen saturation and haemoglobin of a continuous on-line monitor (CDI-100) agree with those of the ABL-4 bloodgasmonitor or the haemoglobincyanid method in hospital laboratory. The study group consisted of 21 patients, with comparable conditions of anesthesia and ECC set-up. ⋯ All values (except one value) are situated within the limits of agreement. Bias of hemoglobin measurement (CDI-100 versus hospital laboratory) is 0.2, 0.0 and 0.1 gr/dl, and all values are situated within the limits of agreement. The results confirm that the CDI-100, in the set-up as described, can be used as a reliable instrument to monitor venous oxygen saturation and haemoglobin during ECC.
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This review focuses on the effects of the newest volatile anesthetic, sevoflurane, on the cardiovascular system. In general, the cardiovascular effects of sevoflurane are quite similar to isoflurane but quite different from desflurane. Sevoflurane is not associated with increases in heart rate in adult patients and volunteers whereas higher MAC of isoflurane and desflurane and rapid increases in the inspired concentrations of these two agents have been associated with increased heart rates in unstimulated volunteers. ⋯ Sevoflurane decreases myocardial contractility similar to equi-MAC concentrations of isoflurane and desflurane and does not potentiate epinephrine-induced cardiac arrhythmias. In several multi-center studies where patients with coronary artery disease or patients at high risk for coronary artery disease were randomized to receive either sevoflurane or isoflurane for cardiac or noncardiac surgery, the incidence of myocardial ischemia and infarction did not differ between treatment groups. Thus, sevoflurane has not been associated with untoward cardiovascular changes in volunteers and patients undergoing elective surgery and may have less potent effects on the vascular smooth muscle of select circulations.
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Acta Anaesthesiol Belg · Jan 1996
Case ReportsTransient radicular irritation followed by meningitis after spinal anesthesia.
Neurotoxicity of spinally administered hyperbaric 5% lidocaine is becoming a serious concern in view of the recent literature. We report a case of probable neurotoxicity of hyperbaric 5% lidocaine, followed by an aseptic meningitis. This case report emphasizes the danger of using hyperbaric 5% lidocaine in a too high dose while performing spinal anesthesia.