Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 1998
Randomized Controlled Trial Comparative Study Clinical TrialTactile evaluation of the response to double burst stimulation decreases, but does not eliminate, the problem of postoperative residual paralysis.
Routine perioperative monitoring with accelero-myography might prevent residual block, whereas routine tactile evaluation of the response to train-of-four (TOF) nerve stimulation does not. The purpose of this prospective, randomised and blinded study was to evaluate the effect of manual evaluation of the response to double burst stimulation (DBS3.3) upon the incidence of residual block. ⋯ Routine perioperative manual evaluation of the responses to TOF and DBS3.3 decreased the incidence and the degree of residual block following the use of pancuronium. It did not, however, exclude clinically significant residual paralysis, nor did it influence the amount of pancuronium used during the operation, the duration of anaesthesia or the time from end of surgery to tracheal extubation or to sufficient recovery of neuromuscular function (TOF = 0.8).
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Acta Anaesthesiol Scand · Nov 1998
Randomized Controlled Trial Comparative Study Clinical TrialRespiration during emergence from anaesthesia with desflurane/N2O vs. desflurane/air for gynaecological laparoscopy.
The complications related to anaesthesia usually occur in the early postoperative period. Hypercapnia and hypoxaemia may result from any persistent depression of the respiratory drive relative to the metabolic demand. The purpose of this study was to compare the respiratory effects of desflurane anaesthesia with or without nitrous oxide during the period of emergence. ⋯ The respiratory profiles during recovery from gynaecological laparoscopy with either desflurane/N2O or desflurane anaesthesia were similar with fast resumption of spontaneous breathing, short time to extubation, and no signs of CO2 retention.
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Acta Anaesthesiol Scand · Nov 1998
Multicenter Study Clinical TrialEffect of learning during an anaesthesiological multicentre trial.
After the completion of a multicentre study, it was disputed whether becoming acquainted with a novel drug would affect dosing, and how many consecutive patients would be sufficient for this phenomenon. ⋯ This study shows that the learning effect can influence the results in a multicentre study. Learning contamination may occur if a novel drug is dosed by clinical judgement, and if the allocation of patients into groups is markedly uneven during the different stages of the study.
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Acta Anaesthesiol Scand · Nov 1998
Effects of recruitment of collapsed lung units on the elastic pressure-volume relationship in anaesthetised healthy adults.
The elastic pressure-volume (Pel-V) curve of the respiratory system can be used as a guide for improved ventilator management. The understanding of curves recorded for sick patients can be improved with better knowledge of the Pel-V relationship observed in healthy humans. Dynamic Pel-V curves were determined over an extended volume range in 15 anaesthetised and muscle-relaxed healthy humans. The influence of a recruitment manoeuvre was studied. ⋯ Pel-V curves recorded before and after the recruitment manoeuvre show that large lung compartments close during anaesthesia and that high pressures are needed to achieve recruitment even in the normal lung. Accordingly, the LIP does not define the end of recruitment during insufflation.
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Acta Anaesthesiol Scand · Nov 1998
Effect of CPAP during cardiopulmonary bypass on postoperative lung function. An experimental study.
Respiratory failure secondary to cardiopulmonary bypass (CPB) remains a major complication after cardiac surgery. We tested the hypothesis that post-CPB lung function impairment can be prevented by continuous positive airway pressure (CPAP) applied during the CPB. ⋯ We conclude that in this pig model post-CPB atelectasis is not effectively prevented by CPAP applied during CPB.