Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 1999
Block of the brachial plexus branches by the humeral route. A prospective study in 503 ambulatory patients. Proposal of a nerve-blocking sequence.
Brachial plexus is usually approached by the supraclavicular or axillary route. A technique for selective blockade of the branches of the plexus at the humeral canal using electrolocation has recently been proposed. The aim of the present study was to assess the feasibility of this technique in the ambulatory patient and to determine the optimal sequence of nerve-blocking. ⋯ This study shows that the nerve block at the humeral canal is an efficient and safe technique. Considering the onset times of nerve blocks, the following sequence for blockade can be recommended: median, ulnar, radial, musculocutaneous, medial (brachial and antebrachial) cutaneous nerves. The selective blockade of the main nerves of the upper limb at the humeral canal can be recommended for surgery of the forearm and the hand in the ambulatory patient.
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Acta Anaesthesiol Scand · Jul 1999
Randomized Controlled Trial Clinical TrialPollution with nitrous oxide using laryngeal mask or face mask.
As environmental pollution by nitrous oxide may influence the health of the personnel working in operating theatres, the incidence and magnitude of nitrous oxide (N2O) leakage, when using a face mask or a laryngeal mask airway (LMA) for controlled ventilation, were studied in 34 patients scheduled for elective cystoscopy. ⋯ Environmental pollution was less with the LMA than the face mask, but under the conditions of the study both modes of airway management were associated with levels of N2O peak concentrations in the breathing zone of anaesthetists that are deemed to be excessively high by the Danish National Institute for Occupational Safety.
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Acta Anaesthesiol Scand · Jul 1999
An alternative method to intubate with laryngeal mask and see-through-bougie.
Different ways of managing the difficult airway is an important issue for the anaesthetist. We have investigated a technique with a see-through-bougie and laryngeal mask for intubation. ⋯ We conclude that intubation using a see-through-bougie and a laryngeal mask is a valuable method in the difficult intubation situation, when a temporary airway can be achieved with laryngeal mask, since it permits continuous ventilation and visual control throughout the procedure.
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Acta Anaesthesiol Scand · Jul 1999
Investigation of fading responses induced by non-depolarising muscle relaxants in the evoked EMG of the gastrocnemius muscle of the cat.
During partial neuromuscular blockade indirect repetitive nerve stimulation causes fade in the response of the muscle. We studied the intensity of the fade induced by intravenous administration of three steroidal muscle relaxants, and investigated the mechanism of fade by comparing with results obtained during partial blockade with animal toxins and vesamicol. ⋯ Our results suggest that non-depolarising muscle relaxant-induced fade is caused by an inhibitory effect on acetylcholine release. Pancuronium seems to have a higher potency of presynaptic inhibition of acetylcholine release than both rocuronium and vecuronium.
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Acta Anaesthesiol Scand · Jul 1999
Pharmacology of G-1-64, a new nondepolarizing neuromuscular blocking agent with rapid onset and short duration of action.
Chances are slim that a clinically useful ultra-short-acting neuromuscular blocking agent of rapid onset will emerge from the benzylisoquinolinium or the aminosteroid series to which all currently popular relaxants belong. G-1-64 is a promising prototype of a new series of bis-quaternary ammonium salt of bistropinyl diester derivatives we have synthesized and studied in the laboratory. ⋯ With favorable neuromuscular blocking characteristics and modest side effects, G-1-64 and similar derivatives may have clinical potential.