Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 1999
Use of Anaesthesia Simulator: initial impressions of its use in two Belgian University Centers.
459 trainees in Anesthesia and Intensive Care Medicine, accompanied by fully certified specialists from several Belgian University Hospital Centers, spend at least a 3 hour session at the Anaesthesia Simulator. Each session comprises three segments: the briefing, the simulation session and the debriefing. The use of simulations allows significant individualization of the learning experience. ⋯ Two University Centers (ULg and UCL) have each organized simulator sessions despite some differences in their approaches. The simulator is a teaching tool worthy of an obligatory role in the most up-to-date training possible of modern anesthesiologist. This is all the more important given that the current practice of anesthesiology is so complex that any error could cost a human life.
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Acta Anaesthesiol Belg · Jan 1999
Randomized Controlled Trial Comparative Study Clinical TrialThe analgesic effect of preoperative administration of propacetamol, tenoxicam or a mixture of both in arthroscopic, outpatient knee surgery.
A prospective, randomized, double-blind, placebo-controlled, comparative study was undertaken to assess the efficacy of the preemptive use of propacetamol, tenoxicam or the combination of both in arthroscopic, outpatient surgery of the knee. One hundred patients aged 18 to 65 years, ASA 1-2, scheduled for arthroscopy were randomized to receive propacetamol 30 mg/kg i.v. (repeated after 6 hours), tenoxicam 0.5 mg/kg i.v. (max. 40 mg), the combination of both or placebo one hour prior to a standard anesthetic. There were no differences with regard to total dose opioid consumption, sedation scores and side effects in the four groups.
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Acta Anaesthesiol Belg · Jan 1999
Randomized Controlled Trial Comparative Study Clinical TrialThe impact of nitrous oxide on postoperative nausea and vomiting after desflurane anesthesia for breast surgery.
A recent meta-analysis showed that omitting N2O significantly reduced postoperative vomiting (POV) compared with a N2O regime. Our study was designed to evaluate the effect of the combination of desflurane with N2O versus desflurane alone on postoperative nausea and vomiting (PONV) in a subgroup of female patients and PONV was considered as the primary endpoint. After approval of the local Ethics Committee and informed consent 60 female in-patients (ASA I & II), aged 18-65 y, scheduled for breast surgery with a duration of 1-3 h were included. ⋯ In addition, there were no significant differences in the amount of intraoperative fentanyl or postoperative narcotics. The incidence of PONV was significantly higher in the group of patients receiving desflurane in N2O-O2 mixture compared with the group receiving desflurane in AIR-O2 mixture. The combination of desflurane with N2O in female patients undergoing breast surgery is associated with a significantly higher incidence of PONV and a higher need of antiemetic drugs, when compared to a N2O free regime.
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Acta Anaesthesiol Belg · Jan 1999
Randomized Controlled Trial Clinical TrialSlow EEG-power spectra correlate with haemodynamic changes during laryngoscopy and intubation following induction with fentanyl or sufentanil.
We studied nociception-associated arousal following laryngoscopy and intubation in patients scheduled for elective open heart surgery, using EEG power spectra and hemodynamics. Either fentanyl (7 micrograms/kg; n = 30) or sufentanil (1 microgram/kg; n = 30) were given in a randomized fashion to induce anesthesia in heavily premedicated patients, followed by pancuronium bromide (100 micrograms/kg). EEG-power spectra (delta, theta, alpha, beta) as well as mean arterial blood pressure (MAP) and heart rate (HF) were measured at the following end-points: before the induction of anesthesia (control), 1 and 10 minutes after laryngoscopy and intubation (L & I). ⋯ Also there was little correlation of SEF with HF and MAP changes (r2 = 0.09 and r2 = 0.02 respectively). Among the EEG-spectra, reduction of power in the slow delta- and theta-bands are the most sensitive parameters to determine insufficient antinociception of opioids commonly used for the induction in cardiac anesthesia. Increase of power in the alpha-band seems to be closely correlated with cortical reactivation and reduction of hypnosis, while a reduction of power especially in the deltabut more so in the theta-band of the EEG reflects nociception related arousal.