Acta anaesthesiologica Scandinavica
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Because pregnancy increases the sensitivity of nervous tissue to local anaesthetics, pregnant patients may be at higher risk of developing neurologic deficits after spinal block than non-pregnant patients. Therefore, we evaluated prospectively the incidence and type of neurologic symptoms after spinal anaesthesia with hyperbaric bupivacaine for caesarean section. ⋯ Women after caesarean section under a spinal block seem to suffer more often from TNSs than non-pregnant women. The conclusions are, however, uncertain since we had no control group operated on under other than spinal anaesthesia. The persisting neurologic symptoms in two patients might also be due to the obstetric procedure itself. To find out about the validity and possible underlying causes of our results, we need randomised studies with control groups receiving epidural or general anaesthesia.
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Acta Anaesthesiol Scand · Jan 2001
Case Reports Clinical TrialComplaints related to respiratory events in anaesthesia and intensive care medicine from 1994 to 1998 in Denmark.
In Denmark, a National Board of Patients' Complaints (NBPC) was founded in 1988. This study analyses anaesthetic complaints related to adverse respiratory events filed at the NBPC from 1994 to 1998 to point out directions for possible preventive measures. ⋯ Complaints related to respiratory events reveal that inadequate anaesthetic and intensive care medicine treatment leads to patient damage and death. Preventive strategies should be directed at the development of guidelines for handling the difficult airway, education in the management of the difficult airway, instruction in the correct use of anaesthetic equipment, improvement of interpersonnel communication routines, as well as implementation of simulator training.
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Acta Anaesthesiol Scand · Jan 2001
Clinical TrialValidation of a new respiratory inductive plethysmograph.
The respiratory inductive plethysmograph (RIP) can be used to monitor changes in end-expiratory lung volume (deltaEELV), and thus, used in intensive care when evaluating positive end-expiratory pressure (PEEP)-induced changes in lung volumes in order to optimise the ventilator settings. We validated the newest model of RIP (Respitrace Plus), both under laboratory and clinical conditions, and made a comparison with a previously validated RIP (Respigraph) in the measurement of tidal volume (V(T)), long-term EELV and PEEP-induced acute deltaEELV. ⋯ The new RIP is accurate enough for clinical and research purposes in the measurement of V(T). Semiquantitative measurements of acute deltaEELV can be done with accuracy sufficient for clinical use, but long-term deltaEELV monitoring is not possible. The new RIP should be kept on for several hours before measurements to minimise the drift.
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Acta Anaesthesiol Scand · Jan 2001
Clinical TrialA single-injection, multi-segmental paravertebral block-extension of somatosensory and sympathetic block in volunteers.
It is our experience that a deposition of an anesthetic solution in the ventral area of the paravertebral space near the parietal pleura and the sympathetic trunk produces extended unilateral block. Because sympathetic block effects in this extended paravertebral block are not reported yet, we undertook this singly blinded, controlled study on the sympathetic change in volunteers. ⋯ One-sided extended analgesia (sensory loss) follows the paravertebral injection of lidocaine. A large ipsilateral sympathetic block is observed without change in pulse rate and with no hypotension. These are all characteristics of an optimal regional block.