Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2001
Randomized Controlled Trial Comparative Study Clinical TrialBronchial blocker compared to double-lumen tube for one-lung ventilation during thoracoscopy.
Video-assisted thoracoscopic surgery (VATS) requires one-lung ventilation with a properly collapsed lung. This study compared the Broncho-Cath double-lumen endotracheal tube with the Wiruthan bronchial blocker to determine the advantages of one device over the other during anaesthesia with one-lung ventilation for thoracoscopy. ⋯ It took significantly longer to place a left BB than a DLT (P<0.0006) or a right BB (P<0.008). The number of initial malpositionings of the left BB was significantly greater than in the other groups (P<0.001). The quality of lung deflation was better in the BBL and in the DLT groups than in the BBR group. We conclude that for routine use during left-sided VATS, the use of a DLT is preferable to a left BB because of its greater ease of placement. For right-sided VATS, DLT and right BB showed the same facility of placement but the DLT provided a better quality of lung deflation.
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* Mechanically ventilated patients with severe acute lung insufficiencies dramatically improve their gas exchange when treated in the prone position. * ventilation heterogeneity is greater in the supine then in the prone position during CMV. * the dominant dorsal Q while supine is not turned into a dominant ventral Q in the prone position. * in the presence of an abdominal distension, the prone position more clearly improves gas exchange than at normal abdominal pressures. * CPAP enhances the dominant dorsal lung perfusion while supine. In the prone position lung perfusion is more uniform. * V/Q matching is improved in the prone position during CMV.
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Acta Anaesthesiol Scand · Feb 2001
Review Case ReportsNo pain relief from codeine...? An introduction to pharmacogenomics.
Drug treatment remains a mainstay of medicine. In some situations a drug unexpectedly has no effect, or unforeseen serious side effects occur. For the patient this represents a dangerous and potentially life-threatening situation. ⋯ Modern biotechnology would be unthinkable without the aid of computers, and we briefly touch upon the field of bioinformatics. Finally, we give an overview of pharmacogenomics in the narrower sense. The rapidly growing field of pharmacogenomics is going to influence our everyday practice of medicine in the immediate future.
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Acta Anaesthesiol Scand · Feb 2001
Randomized Controlled Trial Clinical TrialTransient neurologic symptoms after spinal anaesthesia using isobaric 2% mepivacaine and isobaric 2% lidocaine.
Transient Neurological Symptoms (TNS) syndrome following subarachnoid anaesthesia was initially associated with hyperbaric lidocaine 50 mg/ml, but has also been reported with most local anaesthetics, including hyperbaric mepivacaine 40 mg/ml. The aim of this study was to determine the incidence of TNS after subarachnoid anaesthesia using isobaric mepivacaine 20 mg/ml and isobaric lidocaine 20 mg/ml. ⋯ In this study TNS was associated with isobaric mepivacaine 20 mg/ml, with an incidence of 7.5%, and with isobaric lidocaine 20 mg/ml, with an incidence of 2.5%, in patients having orthopaedic procedures in the supine position.
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Acta Anaesthesiol Scand · Feb 2001
Randomized Controlled Trial Clinical TrialOn-site coagulation monitoring does not affect hemostatic outcome after cardiac surgery.
Rapid coagulation tests are now available for monitoring of bleeding patients after cardiac surgery. As inappropriate blood use in these patients may be due to lack of timely coagulation data, we studied the effect of an algorithm with on-line coagulation monitoring on transfusions in these patients. ⋯ Algorithm-based therapy increased utilization of hemostatic interventions during the immediate recovery period without any obvious benefit to the hemostatic outcome. Re-evaluation of the platelet transfusion trigger seems warranted.