Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 1999
ReviewPresent state of closed-loop drug delivery in anesthesia and intensive care.
Although closed-loop systems have a long tradition in engineering, their continued use for patient care is limited to the last 20 years, with the exception of BICKFORD's pioneering work in 1950. During the past 2 years it has been shown that automated closed-loop systems for drug delivery can provide unique study designs for clinical research allowing experimental setups not realizable by traditional means. It is, however, evident that a lot of research and development has to be done on therapeutic closed-loop systems to solve the many questions related to their reliability, safety and use in the routine clinical setting.
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It is not always necessary or desirable for a block to extend over a wide area, involve the sympathetic system or act bilaterally. Many blocks are capable of providing excellent analgesia in a limited area of the body and with minimal systemic effect. ⋯ Since analgesic requirements and duration of a single dose local anesthetic vary greatly, patients can be expected to obtain better analgesia if they could control the amount and timing of local analgesic medication by PCRA. A new technique is described that allows the patient to self-administer a prescribed dose of local anesthetic at home.
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Acta Anaesthesiol Belg · Jan 1999
Transition time: a new parameter coinciding with fair intubating conditions.
With rocuronium optimal intubating conditions are earlier achieved than the adductor pollicis muscle onset time. Using the transition time we defined a better parameter for clinical relaxation. The onset of relaxation was determined in 20 patients. ⋯ The intubating conditions were significantly better at a relaxation level corresponding with the transition time. We conclude that the transition time approximates the intubating time and corresponds with fair intubating conditions. This parameter can be preferred to define the moment with optimal intubating conditions.
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Acta Anaesthesiol Belg · Jan 1999
Comparative StudyAssessment of the postoperative residual curarisation using the train of four stimulation with acceleromyography.
The aim of this study was to measure the incidence of patients with train of four ratio < 0.9 in the immediate postoperative period using acceleromyography. At arrival in recovery room, 257 patients were enrolled. Train of four ratio was assessed at the adductor pollicis using TOF-GUARD INMT apparatus. ⋯ Patients in group 1 (n = 72) received a higher dose (54.58 +/- 38.03/41.43 +/- 19.47 mg) of atracurium compared to group 2 (n = 176). Thirty percent of patients presented a train of four ratio < 0.7 and 13% < 0.9. TOF-GUARD INMT was easy to use.