Articles: anesthetics.
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Acta Anaesthesiol Scand · Oct 1986
Epidural catheters of the multi-orifice type: dangers and complications.
A study on epidural catheters of the multi-orifice type, investigating their tendency to epidurovasal (with an intravascularly positioned catheter tip) and epidurosubarachnoid (with the catheter tip inserted in the subarachnoid space) malpositioning, was conducted on 113 patients using clinical and radiological criteria as controls. Of the improperly placed catheters, 13 were in an epidurovasal (11.5%) and one was in an epidurosubarachnoid (0.9%) position. ⋯ The insufficiency of controlling or even recognizing such improperly placed catheters which are only partially in the epidural space, as well as the danger of causing a secondary dural or vascular perforation with epidural catheters, is discussed. Since epidural catheters of the multi-orifice type apparently represent an inherent, vital danger due to their construction (regardless of the catheter material and workmanship), they should no longer be used.
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Randomized Controlled Trial Clinical Trial
[Lung compliance in man is impaired by the rapid injection of alfentanyl].
To demonstrate opioid-induced muscular rigidity, compliance was measured in patients after induction of anaesthesia with etomidate (0.3 mg/kg) and N2O/O2 (2:1) ventilation. Alfentanil was given subsequently to two groups of patients: either as a bolus injection (n = 15) over 3 s, or as a slow injection (n = 15) over 30 s. Significant reduction of compliance (max. 30%) was observed after rapid injection in the following 4 min. ⋯ The slow injection of the opioid over 30 s, was followed by a small insignificant reduction in compliance. Alfentanil is increasingly used for short-term anaesthesia where no muscle relaxants are administered. Thus slow injection of the opioid is advised in order not to impair adequate ventilation.