Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1996
Randomized Controlled Trial Clinical TrialThermoregulatory response in female patients during lower abdominal surgery in the head-down tilt position.
The head-down tilt (HDT) position suppresses sympathetic nervous activity. We investigated the effect on thermoregulation of the HDT position during lower abdominal surgery under general anaesthesia. ⋯ During lower abdominal surgery the head-down tilt position does not augment core hypothermia in spite of suppressed peripheral vasoconstriction, and the renin-angiotensin system may be of importance for thermoregulation.
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Acta Anaesthesiol Scand · Apr 1996
Effect of inhaled nitric oxide on venous admixture depends on cardiac output in patients with acute lung injury and acute respiratory distress syndrome.
It has been shown that inhaled nitric oxide (NO) reduces intrapulmonary venous admixture (QVA/QT) and improves oxygenation in patients suffering from acute respiratory distress syndrome (ARDS). The change in QVA/QT during NO inhalation varies individually. Factors known to influence the respiratory response to NO are the NO concentration and the level of shunt before NO administration. Other factors that may modify the effect on gas-exchange during NO breathing are unknown. ⋯ We conclude that the change in venous admixture during inhalation of 40 ppm NO depends on cardiac output. If preinhalation cardiac output is high, 40 ppm NO can adversely affect gas exchange in patients with ALI and ARDS.
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Acta Anaesthesiol Scand · Apr 1996
Randomized Controlled Trial Clinical TrialRectal administration of morphine in children. Pharmacokinetic evaluation after a single-dose.
There is limited knowledge about the pharmacokinetics of morphine and its metabolites after rectal administration in children. In this study the pharmacokinetics of two different rectal formulations of morphine were examined and compared with intravenous morphine. ⋯ The rectal morphine hydrogel has pharmacokinetic properties which makes it a useful formulation for premedication and pain alleviation in paediatric patients.
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Acta Anaesthesiol Scand · Apr 1996
Randomized Controlled Trial Clinical TrialA cost-benefit evaluation of using propofol and alfentanil for a short gynecological procedure.
It is well established that the immediate recovery after propofol or alfentanil anesthesia is short. Although the drugs themselves are more expensive than older drugs, a potential for saving costs arises. Concerning the benefits in terms of late recovery, less information is available. ⋯ At the time of the study each patient was paid 210 SEK/day from the social insurance system and the mean cost of the drugs was 72 and 15 SEK/patient in the PA- and TN-groups, respectively. Using the mean difference in sick-leave between the groups of 0.8 days/patient (rather than the difference in median values of 1), a net gain of 111 SEK/patient was the result of changing from thiopental-nitrous oxide anesthesia to propofol-alfentanil anesthesia. Although the cost of drugs was higher, costs for the social insurance system and for the individuals themselves were reduced by almost 50%, when using the propofol and alfentanil combination, resulting in an overall benefit corresponding to almost twice the increase in the cost of anesthesia.
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Acta Anaesthesiol Scand · Apr 1996
Comparative StudyMalignant hyperthermia (MH) diagnostics: a comparison between the halothane-caffeine- and the ryanodine-contracture-test results in MH susceptible, normal and control muscle.
Recent studies demonstrated different contracture responses in muscle from malignant hyperthermia susceptible (MHS) compared to normal (MHN) individuals following exposure to the plant alkaloid ryanodine in-vitro. To confirm if ryanodine has a specific action in MHS muscle, the effect of a single concentration was investigated in skeletal muscle from MHS, MHN and control subjects using a new evaluation technique. In-vitro contracture test (IVCT) and MH diagnosis were performed according to the European Protocol in 86 patients sent to us for MH diagnostic testing and in 24 controls. ⋯ These results suggest that MHS muscle has a higher sensitivity to ryanodine. However, the protocol should be investigated for reproducibility and validation of thresholds by other laboratories. Ryanodine can help to improve MH diagnostic tests.