Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2000
Randomized Controlled Trial Clinical TrialEpidural PCA with bupivacaine 0.125%, sufentanil 0.75 microgram and epinephrine 1/800.000 for labor analgesia: is a background infusion beneficial?
Eighty term parturients requesting epidural analgesia for labor pain treatment were randomly assigned to receive bupivacaine 0.125%, sufentanil 0.75 microgram/ml and epinephrine 1/800.000 by PCA modality with or without a basal rate of 3 ml/hr. A loading of 10 ml using the same mixture was administered while the PCA-demand dose consisted of 3 ml (lock out time 12 minutes). ⋯ We conclude that for shortlasting labors, a low dose epidural PCA regimen results in a dose-sparing effect when compared to PCEA combined with a background infuson. For longer-lasting labors no differences between the two modalities could be observed.
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Acta Anaesthesiol Belg · Jan 2000
Randomized Controlled Trial Clinical TrialEffects of ephedrine on the onset time of neuromuscular block and intubating conditions after cisatracurium: preliminary results.
We studied the effects of intravenous ephedrine on the onset time and the intubating conditions 2 min after a bolus dose of cisatracurium (0.15 mg kg-1). Thirty patients anaesthetized with sufentanil and propofol were randomly divided in 2 groups to receive either ephedrine (70 micrograms.kg-1) or saline, 5 s before propofol. Cisatracurium was administered after loss of consciousness. ⋯ The frequency of excellent intubating conditions was higher after ephedrine (86.6%) than after saline (40.0%). The onset time of cisatracurium was shorter after ephedrine (167 +/- 64.8 s vs 234.9 +/- 63.1 s). Thus, a low dose of ephedrine given before induction of anaesthesia improves the intubating conditions 2 min after 0.15 mg kg-1 cisatracurium and this effect likely relates to a quicker onset of neuromuscular block.
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Acta Anaesthesiol Belg · Jan 2000
ReviewDay surgery, including the preoperative assessment of the patient: a UK experience by a Belgian anaesthetist.
In some European countries like Belgium, a lot of hospitals are today dealing with two extremely real issues: adult day surgery and the preoperative anaesthesia consultation. Although efforts are made, there is often still a search for a clear-cut identity on these subjects. As in the rest of Europe, Belgian political, financial and medical driving forces are strongly favouring the shift of surgical procedures towards more day care practice. ⋯ The nursing director, as well as the medical director of the day unit will have to use their power in order to avoid abuse of ambulatory beds for other purposes. As the perioperative specialist, the anaesthetist is ideally suited for the pre-, per-, and postoperative management of the ambulatory patient. Moreover, concerning the preoperative assessment clinic, UK anaesthetists have organized a valuable and interesting alternative to the expensive and time/manpower consuming system used in the USA.
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Acta Anaesthesiol Belg · Jan 2000
Practice Guideline Guideline"Recommendations for uniform reporting of data following major trauma--the Utstein style" (as of July 17, 1999). An International Trauma Anaesthesia and Critical Care Society (ITACCS).
Basic and advanced care of trauma patients has always been an important aspect of prehospital and immediate in-hospital emergency medicine, involving a broad spectrum of disciplines, specialties and skills delivered through Emergency Medical Services Systems which, however, may differ significantly in structure, resources and operation. This complex background has, at least in part, hindered the development of a uniform pattern or set of criteria and definitions. This in turn has hitherto rendered data incompatible, with the consequence that such differing systems or protocols of care cannot be readily evaluated or compared with acceptable validity. ⋯ Head to 9. External; the physiological disability scale ranging ordinally from 0--unsurvivable. Mechanism of injury recording for transportation incidents etc. e.g. the type of impact, po