Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2004
Clinical TrialRemifentanil for foetal immobilisation and maternal sedation during endoscopic treatment of twin-to-twin transfusion syndrome : a preliminary dose-finding study.
Twin to twin transfusion syndrome (TTTS) affects 10 to 15% of monochorionic twin pregnancies. Untreated, perinatal loss exceeds 80%, of which survivors have a great risk for long-term neurological disorders as psychomotor retardation or cerebral palsy. TTTS can be treated using foetoscopy and selective ablation of the twin-to-twin blood vessels under local or regional anaesthesia. ⋯ In no mother apnoe occurred. All haemodynamic parameters, both foetal and maternal, remained stable during the procedure. Maternal sedation, respiratory depression and foetal immobilisation were quickly reversible following cessation of the remifentanil infusion.
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Acta Anaesthesiol Belg · Jan 2004
Randomized Controlled Trial Comparative Study Clinical TrialRecovery from neuromuscular block after an intubation dose of cisatracurium and rocuronium in lumbar disc surgery.
Residual muscle paralysis remains a concern for anaesthesiologists. This study investigated the recovery from neuromuscular block (NMB) after an intubation dose of cisatracurium (C) or rocuronium (R) in 32 patients undergoing lumbar disc surgery. ⋯ A single dose of cisatracurium or rocuronium may be associated to some degree of NMB at the end of lumbar surgery, depending on the duration of surgery and on the duration of action of the muscle relaxant which is more variable for rocuronium than for cisatracurium.
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Acta Anaesthesiol Belg · Jan 2004
Review Comparative StudyPerioperative management for one day hospital admission: regional anesthesia is better than general anesthesia.
The past ten years have showed real and considerable growth in the number and complexity of ambulatory surgeries. The remaining real problems are the postoperative pain and the adverse effects due to parenteral opioids promoting hospital readmissions and increasing costs. ⋯ Regional anesthesia techniques such as spinal anesthesia and peripheral nerve blocks are ideal techniques for one day hospital admissions surgical procedures. It is now fully demonstrated that these techniques allowed rapid and complete anesthetic blocks, a limitation of adeverses events and unplanned hospital admissions and increased the quality of prolonged optimal postoperative pain relief if continuous peripheral nerve blocks are used.
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Acta Anaesthesiol Belg · Jan 2004
ReviewManagement of fetal pain during invasive fetal procedures. A review.
In recent years, fetal stress and analgesia draw more and more attention. Evidence that fetuses show a significant endocrinological and hemodynamical response to invasive stimuli, and that these responses can be blocked by analgesia, suggests that fetuses experience a stress response, even if this does not signify they experience "pain". Moreover, it is becoming increasingly clear that experiences of pain of a fetus will be "remembered" by the developing nervous system, perhaps for the entire life of the individual, which can probably lead to abnormal behavioural patterns or altered nociception. But up to now, the entire mechanism of fetal stress response and the optimal analgesic drug, dose and route of administration is not so clear.