Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2003
Intradermal skin testing in the investigation of suspected anaphylactic reactions during anaesthesia--a retrospective survey.
An anaphylactic reaction is a rare, but severe anaesthetic complication. In this retrospective survey we report on patients with a severe suspected anaphylactic reaction during anaesthesia and the investigation with intradermal skin testing of these suspected anaphylactic reactions. In the patients with an anaphylactic reaction to neuromuscular blocking drugs, the subsequent anaesthetic history was examined. ⋯ In 47 patients skin testing was performed and 43 of these patients had positive skin tests: neuromuscular blockings drugs and succinylcholine more specifically, were the most frequently incriminated drugs. After the anaphylactic reaction 19 patients had surgery on 26 occasions with the use of a skin-test-negative neuromuscular blocking drug; no problems occurred. Skin testing proved to be a reliable tool to investigate suspected anaphylactic reactions during anaesthesia and to guide the future use of neuromuscular blocking drugs.
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Acta Anaesthesiol Belg · Jan 2003
Case ReportsOnce a post-dural puncture headache patient always post-dural puncture headache patient?
It is well known that symptoms of post-dural puncture headache (PDPH) are more likely if there has been a preceding PDPH. We herein present a patient who developed a PDPH following each of two dural punctures separated by 9 years.
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Acta Anaesthesiol Belg · Jan 2003
Case ReportsAmphetamine abuse in pregnancy: anesthetic implications.
The prevalence of recreational substance abuse amongst young adults (including women in child-bearing age) has markedly increased over the past two decades and it remains one of the major problems facing our society today--worldwide. Amphetamine is one of the most common substances abused in pregnancy and one of the most potent sympathomimetic amines with respect to stimulatory effects on the central nervous system. The following case report illustrates the problems that may arise during anesthesia in the parturient with recent amphetamine intake.
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International guidelines developed recommendations in the resuscitation of the new-born: at least one person trained in resuscitation of the newly born should attend every delivery. A minority of the new-borns require active resuscitation to achieve regular respiration, heart rhythm above 100/min, pink colour and adequate tone. Establishment of adequate ventilation should be of primary concern. ⋯ Very few infants require chest compressions and much less administration of drugs. Umbilical access remains the most widely recommended access in new-born. Adequate transfer to Neonatal Unit improves outcome.
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Acta Anaesthesiol Belg · Jan 2002
Randomized Controlled Trial Clinical TrialA randomized study of the efficacy and recovery of remifentanil-based and alfentanil anaesthesia with desflurane or sevoflurane for gynecological surgery.
We performed a prospective, randomized study comparing the efficacy and safety of the combination of remifentanil and the newer volatile anaesthetics desflurane and sevoflurane with a conventional anaesthetic technique using alfentanil and desflurane. Forty five ASA class I or II female patients were randomly assigned to one of three groups. Following induction with propofol patients received a continuous infusion of remifentanil in combination with either 0.5 MAC desflurane (n = 15) or sevoflurane (n = 15), a third group (n = 15) received 1 MAC of desflurane with bolus doses of alfentanil for maintenance of anaesthesia. ⋯ Recovery times were similar in all groups. The incidence of postoperative side effects was high in the three groups. No awareness occurred and patient satisfaction in the two remifentanil groups was comparable to the conventional anaesthetic technique.