Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Oct 1997
Randomized Controlled Trial Multicenter Study Clinical TrialResidual neuromuscular block is a risk factor for postoperative pulmonary complications. A prospective, randomised, and blinded study of postoperative pulmonary complications after atracurium, vecuronium and pancuronium.
After anaesthesia involving pancuronium a high incidence of both residual neuromuscular block and postoperative pulmonary complications (POPC) has been reported. The aim of this study was to compare the incidence of POPC following the use of pancuronium, atracurium, and vecuronium, and to examine the effect of residual neuromuscular block on the incidence of POPC. ⋯ Postoperative residual block caused by pancuronium is a significant risk factor for development of POPC.
-
Acta Anaesthesiol Scand · Oct 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of inhalation inductions with xenon and sevoflurane.
Xenon is an odorless gas with low blood-gas solubility coefficient and without occupational and environmental hazards. This investigation was performed to evaluate the speed of induction, and respiratory and cardiovascular reactions to inhalation induction with xenon compared to an equianesthetic concentration of sevoflurane. ⋯ Xenon produced a faster induction of anesthesia without any complications than sevoflurane. Xenon had smaller decreases in tidal volume and respiratory rate during induction than sevoflurane. Xenon might offer an alternative to sevoflurane for an inhalation induction.
-
Acta Anaesthesiol Scand · Oct 1997
Randomized Controlled Trial Clinical TrialEffective dose of granisetron in the reduction of nausea and vomiting after breast surgery.
Prophylactic use of granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, reduces the incidence of nausea and vomiting after breast surgery. This study was undertaken to determine the minimum effective dose of granisetron in the reduction of postoperative nausea and vomiting (PONV) in patients undergoing general anaesthesia for breast surgery. ⋯ Granisetron 40 micrograms.kg-1 appears to be the minimum effective dose for reducing PONV in patients undergoing general anaesthesia for breast surgery.
-
Acta Anaesthesiol Scand · Oct 1997
Randomized Controlled Trial Clinical TrialMapping of punctuate hyperalgesia around a surgical incision demonstrates that ketamine is a powerful suppressor of central sensitization to pain following surgery.
Tissue injury induces central sensitization in the spinal cord dorsal horn neurons via mechanisms involving N-methyl-D-aspartate (NMDA) receptors, leading to secondary hyperalgesia. Using punctuate mechanical hyperalgesia as a measure of central sensitization, we examined whether induction and maintenance of central sensitization after surgery could be prevented by a low-dose infusion of the NMDA-receptor antagonist ketamine. ⋯ Low-dose i.v. infusion of ketamine during and after surgery reduces mechanical punctuate hyperalgesia surrounding the surgical incision. These results indicate that blockade of NMDA receptors prevents the central sensitization caused by nociceptive input during and after surgery.
-
Acta Anaesthesiol Scand · Oct 1997
Randomized Controlled Trial Clinical TrialLaryngeal mask bite blocks--rolled gauze versus Guedel airway.
Biting on the silicone tube and pilot balloon of the laryngeal mask airway (LMA) may obstruct or damage them with the teeth and a bite block is recommended. The recommended bite block is a wad of gauze swabs rolled into a cylindrical shape and placed alongside the LMA. It is considered that this avoids irritating the posterior pharyngeal wall and damage to teeth whilst supporting the LMA tube when taped to it. The Guedel airway is commonly used as a bite block with the tracheal tube and many anaesthetists also use it with the LMA. The aim of the following study was to compare rolled gauze swabs with a Guedel airway as a bite block for the LMA. ⋯ 1. The Guedel airway is an unsuitable bite block for the LMA. 2. Cuff pressure limitation is compatible with adequate ventilation. 3. The combination of LMA and Guedel airway probably prevents either from sitting in the correct anatomical position.