Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 1998
Randomized Controlled Trial Comparative Study Clinical TrialPercutaneous dilatational tracheostomy versus conventional surgical tracheostomy. A clinical randomised study.
As no clinical randomised studies have previously been performed comparing complications with the Ciaglia Percutaneous Dilatational Tracheostomy Introducer Set (PDT) and conventional surgical tracheostomy (TR), we designed a study with the aim of comparing the efficacy and safety of the two techniques. ⋯ Our results indicate that the percutaneous dilatational tracheostomy technique performed with the Ciaglia Introducer Set is effective, safe and superior to conventional surgical tracheostomy as immediate complications as well as complications with the tracheostomy tube in situ are fewer and of less severity.
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Acta Anaesthesiol Scand · May 1998
Randomized Controlled Trial Comparative Study Clinical TrialComparison of analgesic efficacy of oxycodone and morphine in postoperative intravenous patient-controlled analgesia.
Morphine has been the standard opioid in patient-controlled analgesia (PCA). Oxycodone, the analgesic potency of which in i.v. administration has been suggested to be slightly greater than that of morphine, has not yet been studied for its efficacy in PCA. ⋯ The same dose of intravenous oxycodone and morphine administered by PCA pump was needed for immediate postoperative analgesia. The two drugs appear to be equipotent.
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Acta Anaesthesiol Scand · May 1998
Randomized Controlled Trial Comparative Study Clinical TrialComparison of transarterial and multiple nerve stimulation techniques for an initial axillary block by 45 mL of mepivacaine 1% with adrenaline.
The single-injection axillary block is rapidly performed but gives unpredictable results. Axillary block by multiple nerve stimulation technique (MNS) gives better results, but takes longer to perform. Transarterial (TA) injections of high doses of local anaesthetics are very successful. This double-blind study compared both block effectiveness and anaesthesiologic time consumption in 100 patients, having an axillary block by either TA or MNS techniques. ⋯ In the hands of anaesthetists experienced in nerve electrolocation, the MNS technique of an initial axillary block by four separate injections of 10 mL of mepivacaine produces faster and more extensive block than the TA technique by two separate injections of 20 mL. Hence, the MNS technique requires fewer supplementary blocks and results in faster patient readiness for surgery than the TA technique.
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Acta Anaesthesiol Scand · May 1998
Randomized Controlled Trial Clinical TrialThe inflammatory cytokine response after autotransfusion of shed mediastinal blood.
The inflammatory response in patients undergoing cardiac surgery with cardiopulmonary bypass is well known and increased levels of inflammatory cytokines have been shown. High levels of cytokines have been reported in blood drained from the surgical field. The present study aimed to elucidate whether autotransfusion of shed mediastinal blood in itself causes increased cytokine levels in coronary artery bypass graft (CABG) patients. ⋯ Shed mediastinal blood contains high levels of IL-6. However, autotransfusion of shed mediastinal does not cause measurable elevations in plasma levels of IL-6. In vitro study shows that autotransfusion activates leucocytes, which may enhance production of inflammatory cytokines.
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Acta Anaesthesiol Scand · May 1998
Comparative StudyEffects of intravenous anesthetics on bacterial elimination in human blood in vitro.
Since anesthetics are widely used in critically ill patients, this study investigates anesthetic effects on neutrophil and monocyte function concerning bacterial elimination in human whole blood. ⋯ Thiopental, propofol, midazolam and ketamine affect E. coli clearance and neutrophil and monocyte oxidative burst and phagocytosis in vitro only in high concentrations, while thiopental inhibited monocytic burst and propofol impaired PMN phagocytosis even in clinically used concentrations. These data suggest that i.v. anesthetics in concentrations recommended for general anesthesia seem to have minor influence on the investigated host defense mechanisms.