Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2002
Randomized Controlled Trial Clinical TrialPostoperative muscle paralysis after rocuronium: less residual block when acceleromyography is used.
Residual muscle paralysis after anesthesia is common after pancuronium, but less common following the intermediate-acting drugs vecuronium and atracurium. Therefore, many anesthetists do not monitor neuromuscular function when using an intermediate-acting agent. The purpose of this prospective, randomised and double-blind study was to establish the incidence and degree of postoperative residual block following the use of rocuronium in patients not monitored with a nerve stimulator, and to compare it with results obtained in patients monitored using acceleromyography (AMG). ⋯ Clinical evaluation of recovery of neuromuscular function does not exclude significant residual paralysis following the intermediate-acting muscle relaxant rocuronium, but the problem of residual block can be minimized by use of AMG.
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Acta Anaesthesiol Scand · Feb 2002
Randomized Controlled Trial Comparative Study Clinical TrialParenteral ketoprofen for pain management after adenoidectomy: comparison of intravenous and intramuscular routes of administration.
Different parenteral routes of administration of NSAIDs such as ketoprofen have not been properly compared in children. This study was designed to compare the analgesic efficacy of intravenous and intramuscular ketoprofen for pain management in children after day-case adenoidectomy. ⋯ The efficacy of intravenous and intramuscular ketoprofen was similar, and they both differed from placebo.
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Acta Anaesthesiol Scand · Feb 2002
Randomized Controlled Trial Clinical TrialAlbumin extravasation and tissue washout of hyaluronan after plasma volume expansion with crystalloid or hypooncotic colloid solutions.
Intravascular volume expansion is followed by loss of fluid from the circulation. The extravasation of albumin in this readjustment is insufficiently known. ⋯ Infusion of hypotonic colloidal solutions entails net loss of albumin from the vascular space. This is not the case after Ringer's acetate. Increased interstitial hydration from the latter fluid is followed by lymphatic wash out of hyaluronan.
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Acta Anaesthesiol Scand · Feb 2002
Randomized Controlled Trial Clinical TrialEffect of metoclopramide on mivacurium-induced neuromuscular block.
In order to investigate the effect of metoclopramide on the duration of action of mivacurium, 45 patients were randomized into three groups. Group M10 (n = 15) and M20 (n = 15) received 10 and 20 mg of metoclopramide i.v., respectively, and group S (n = 15) received saline 2 min before induction of anesthesia with fentanyl, thiopental and mivacurium. Plasma cholinesterase activity (pCHE) was measured before induction of anesthesia and 2 min after injection of metoclopramide and saline. ⋯ Time to recovery of a twitch height of 90% was significantly prolonged in group M10 and M20 (44 +/- 15 and 57 +/- 10 min) as compared to group S, 32 +/- 9 min, P < 0.05). A slight but significant decrease in pCHE was observed in group M20. Because of the risk of prolonged duration of action of mivacurium, neuromuscular blockade should always be monitored whenever metoclopramide is given before injection of mivacurium.
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Acta Anaesthesiol Scand · Feb 2002
Clinical evaluation of a partial CO2 rebreathing technique for cardiac output monitoring in critically ill patients.
Monitoring central hemodynamics is essential in critically ill patients and less invasive techniques are needed. In this study, the clinical and technical performance of a new non-invasive cardiac output monitor (NICO) based on partial CO2 rebreathing technique and a modified Fick equation were evaluated. The various sources of possible errors in measurement of cardiac output (CO), carbon dioxide production (VCO2) and pulmonary shunt were also assessed. ⋯ Clinical evaluation shows that partial CO2 rebreathing technique provides a useful and accurate non-invasive estimate of cardiac output. Although this technique cannot fully replace the pulmonary artery catheter, it may be used to monitor central hemodynamics in a large number of critically ill patients.