Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
Randomized Controlled Trial Comparative Study Clinical Trial
Body heat transfer during hip surgery using active core warming.
The purpose of this study was to evaluate the effect of core warming on heat redistribution from the core to the periphery as manifested by changes in core, mean skin temperature and mean body heat, investigated in a group of 30 patients undergoing total hip replacement. The control group (n = 10) had no active warming. Core warming was achieved in the humidifier group (n = 10) by using humidified and warmed gases at 40 degrees C, whilst in the oesophageal group (n = 10), an oesophageal heat exchanger was used to achieve active warming. ⋯ Mean skin temperatures were calculated for a weighted four and unweighted 15 points, and mean body heat were calculated to quantify the distribution of body heat. Core temperature decreased in the control and the oesophageal groups, but not in the humidifier group at the end of surgery; by mean values +/- SD of 1.9 degrees C +/- 0.6, 1.2 degrees C +/- 0.6 and 0.4 degree C +/- 0.2 degree C, respectively (P < 0.01). Mean skin temperature (MST15) decreased in the control group by 1.0 degree C +/- 1.0, but not in the actively warmed groups where the mean increased by 0.1 degree C +/- 1.4 and 0.2 degree C +/- 0.2 in the oesophageal and humidifier groups, respectively (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
-
We report the case of a 65-yr-old woman undergoing bronchoscopy for a lobular lesion who received thiopentone to induce anaesthesia that was maintained with sufentanil, vecuronium and isoflurane. She tolerated the procedure well initially, but developed eruptions about her face and fingers within 24 hr of anaesthesia. ⋯ The surgery was well tolerated and the patient was discharged after an uneventful postoperative course. This case is reported to heighten awareness of the delayed onset of adverse effects which may be associated with the use of thiopentone.
-
Three cases are reported where pre-existing medical conditions (severe osteoporosis, amyotrophic lateral sclerosis, cardiac arrhythmias) made the administration of succinylcholine during ECT potentially dangerous. Therefore, mivacurium was substituted as the muscle relaxant necessary for safe therapy. Full reversal of the non-depolarizing muscle relaxant was assured by post-reversal use of the peripheral nerve stimulator with full recovery of train-of-four response.
-
The study evaluated the warming ability and flow rates associated with four fluid warming devices during pressure driven infusion and during wide open gravity driven roller clamp infusion. Warmers tested were the Astotherm, Flotem IIe, Level 1 System 250 and a modified cardioplegia heat exchanger. Fluids tested were crystalloid, red cells diluted with 200 ml, 0.9% saline, and undiluted red cells. ⋯ Only the System 250 warmed red cells > 35 degrees C at gravity driven flow rates. The Flotem and Astotherm were not effective in warming rapidly infused solutions. None of the warmers tested was able to deliver fluids at normothermia (> 36.5 degrees C).