Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2005
ReviewContinuous interscalene block using a stimulating catheter: a review of the technique.
The management of postoperative pain after major shoulder surgery can be achieved successfully with a continuous interscalene block. This article reviews the essentials of the stimulating catheter technique for the continuous interscalene block that was described by Boezaart in 1999. The authors also describe their experience and results with the first two hundred catheters they placed.
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Acta Anaesthesiol Belg · Jan 2005
Comparative StudyInstallation of the hand influences acceleromyography measurement. A comparison with mechanomyography during neuromuscular recovery.
Acceleromyography is commonly used to monitor perioperative neuromuscular blockade and to prevent residual neuromuscular blockade at the time of tracheal extubation. However, there are problems associated with this method, such as obtaining stable values, particularly beneath the surgical fields. We compared TOF ratios obtained on both hands simultaneously using on one side mechanomyography and on the other acceleromyography, installed in four different ways: the hand simply lying on a board, fingers fixed with tape, use of the hand adaptor or the TOF-tube. Further to maintaining free thumb movement, the TOF-tube improves feasibility of acceleromyography by reducing the measurement variability while retaining accuracy.
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Acta Anaesthesiol Belg · Jan 2005
Incidence of atrial fibrillation early after cardiac surgery: can choice of the anesthetic regimen influence the incidence?
Occurrence of atrial fibrillation is a common complication after coronary surgery. This study aimed to identify the perioperative factors that are associated with its occurrence with specific attention to the possible influence of the choice of the anesthetic regimen after elective coronary surgery. A retrospective chart analysis was performed in 460 patients who underwent elective coronary artery surgery with cardiopulmonary bypass using the standard institutional anesthetic, surgical and postoperative protocols. ⋯ Multiple logistic regression analysis identified increased age (> 70 years), EuroSCORE > 4, prolonged CPB time (> 100 min) and need for prolonged inotropic support (> 6 hours) as the significant independent risk factors for the occurrence of postoperative atrial fibrillation. The incidence of postoperative atrial fibrillation differed among the different anesthetic groups with the lowest incidence in the sevoflurane group (propofol: 17/110; midazolam: 15/90; sevoflurane: 9/150; desflurane: 23/110) (p = 0.004). This finding should be further confirmed in a prospective sufficiently powered multicenter study.
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Acta Anaesthesiol Belg · Jan 2005
Effect of hydroxyethylstarch on renal function in cardiac surgery: a large scale retrospective study.
Recent reports indicated negative effects of hydroxyethylstarch (HES) on renal function. The goal of this large scale retrospective study was to detect whether there was an association between postoperative deterioration of renal function and the use of HES 200 kD, 0.5 DS in the cardiac surgery setting. ⋯ The use of HES 200 kD, 0.5 DS in cardiac surgery does not seem to be associated with a clinically significant deterioration of postoperative renal function.