Acta anaesthesiologica Belgica
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We conducted a one-year prospective study involving a prehospital Emergency Medical Service in the Netherlands to investigate the incidence of failed or difficult prehospital endotracheal intubation. During the study period the paramedics were asked to fill in a registration questionnaire after every endotracheal intubation. Of the 26,271 patient contacts, 256 endotracheal intubations were performed by paramedics in one year. ⋯ The median time between arrival on the scene and a positive capnograph was 7 min.38 s in the case of a Cormack and Lehane grade I laryngoscopy and 14 min.58 s in the case of a Cormack and Lehane grade 4 laryngoscopy. The incidence of endotracheal intubations performed by Dutch paramedics in one year was low, but endotracheal intubation was successful in 95.2%, which is comparable with findings in international literature. Early capnography should be used consistently in prehospital airway management.
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Acta Anaesthesiol Belg · Jan 2011
Three-dimensional magnetic resonance image of structures enclosed in the spinal canal relevant to anesthetists and estimation of the lumbosacral CSF volume.
Three-dimensional (3D) image-reconstruction of structures inside the spinal canal certainly produces relevant data of interest in regional anesthesia. Nowadays, all hospital MRI equipment is designed mainly for clinical diagnostic purposes. In order to overcome the limitations we have produced more accurate images of structures contained inside the spinal canal using different software, validating our quantitative results with those obtained with standard hospital MRI equipment. ⋯ A high variability was detected among cases, without correlation with either weight, height or body mass index. Aspects concerning the partial volume effect are also discussed. Quick semi-automatic hospital 3D reconstructions give results close to detailed neuroanatomical 3D reconstruction and could be used in the future for individual quantification of lumbosacral CSF volumes and other structures for anesthetic purposes.
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Acta Anaesthesiol Belg · Jan 2011
Randomized Controlled TrialOptimum dose of ketamine for prevention of postanesthetic shivering; a randomized double-blind placebo-controlled clinical trial.
Our objective was to investigate the efficacy and the optimum dosage of ketamine for post anesthetic shivering prevention. One-hundred and twenty patients (ASA I-II) scheduled for elective orthopedic surgery were randomly allocated to receive ketamine in 3 groups ; groups A (0.125 mg/Kg), groups B (0.25 mg/Kg) and C (0.5 mg/Kg) along with those receiving 0.9% normal saline as the placebo group. Tympanic temperature was measured immediately after induction of anesthesia, 30 min after induction, before administration of the study drug and by the end of the surgery. ⋯ The frequency of shivering was significantly less in groups B (0.25 mg/Kg) and C (0.5 mg/Kg) than in groups A (0.125 mg/Kg) and D (placebo). In addition recovery, extubation time and hallucination was observed to be less in group B compared to group A. Prophylactic 0.25 and 0.5 mg/kg ketamine was found to be effective in preventing postanesthetic shivering with a better response observed with 0.25 mg/kg dosage.
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Acta Anaesthesiol Belg · Jan 2011
ReviewMedication in the perioperative period: stop or continue? A review.
Preoperative evaluation of medication is important as part of the anesthetic plan. The aim of this manuscript is to evaluate and compare through literature review the existing evidence to support optimal perioperative medication management.
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Acta Anaesthesiol Belg · Jan 2011
Comparative StudyMaintenance of anesthesia in morbidly obese patients using propofol with continuous BIS-monitoring: a comparison of propofol-remifentanil and propofol-epidural anesthesia.
Aim of this study was to evaluate maintenance of anesthesia using propofol with continuous Bispectral Index (BIS)-monitoring in morbidly obese patients receiving propofol-remifentanil and propofol-epidural anesthesia. ⋯ Using both BIS and hemodynamic parameters as an endpoint, a maintenance dose of propofol of 4-6 mg/kg/hr is proposed for maintenance of anesthesia in morbidly obese patients undergoing bariatric surgery either in combination with remifentanil or epidural analgesia. There was no difference in propofol concentration-BIS relation in morbidly obese patients receiving propofol-remifentanil or propofol-epidural anesthesia.