Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2002
Effects of propofol on cerebral blood flow and the metabolic rate of oxygen in humans.
Effects of propofol on human cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO2), and blood flow-metabolism coupling have not been fully evaluated. We therefore assessed the effects of propofol on total-CBF and CMRO2 in patients without noxious stimuli and neurologic disorders. ⋯ Propofol proportionally decreased CBF and CMRO2 without affecting a-vDO2 in humans, suggesting that normal cerebral circulation and metabolism are maintained.
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Acta Anaesthesiol Scand · Aug 2002
Randomized Controlled Trial Clinical TrialNo enhancement of sensory and motor blockade by ketamine added to ropivacaine interscalene brachial plexus blockade.
Ketamine can enhance anesthetic and analgesic actions of a local anesthetic via a peripheral mechanism. The authors' goal was to determine whether or not ketamine added to ropivacaine in interscalene brachial plexus blockade prolongs postoperative analgesia. In addition, we wanted to determine the incidence of adverse-effects in patients undergoing hand surgery. ⋯ This study suggests that 30 mg ketamine added to ropivacaine in the brachial plexus block does not improve the onset or duration of sensory block, but it does cause a relatively high incidence of adverse-effects. These two findings do not encourage the use of ketamine with local anesthetics for brachial plexus blockade.
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Acta Anaesthesiol Scand · Aug 2002
Randomized Controlled Trial Clinical TrialPostoperative pain relief following intrathecal bupivacaine combined with intrathecal or oral clonidine.
The purpose of the present study was to evaluate the postoperative analgesic and adverse effects of equal doses of oral or intrathecal clonidine in spinal anaesthesia with bupivacaine plain. ⋯ Addition of intrathecal clonidine prolonged analgesia and decreased morphine consumption postoperatively more than oral clonidine. Hypotension was more pronounced after oral than after intrathecal clonidine. Intrathecal clonidine is therefore recommended.
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Acta Anaesthesiol Scand · Aug 2002
Randomized Controlled Trial Clinical TrialAuditory evoked potential monitoring with the AAITM-index during spinal surgery: decreased desflurane consumption.
The auditory evoked potential (AEP) is sensitive to the depth of anesthesia. The A-line monitor is a novel device that processes the amplitude and latency of the AEP during the mid-latency time window to provide a simple numerical index, the AAItrade mark-index. The hypothesis of the present study was that titration of anesthetic depth (desflurane) by means of the AAItrade mark-index could decrease the consumption of the main anesthetic and shorten emergence times. ⋯ Titrating depth of desflurane anesthesia using AAItrade mark-index guidance decreased main anesthetic consumption and improved emergence during spine surgery.
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Acta Anaesthesiol Scand · Aug 2002
Case ReportsTracheal esophageal combitube: a useful airway for morbidly obese patients who cannot intubate or ventilate.
The tracheal esophageal combitube has been successfully used in many difficult airway circumstances. We report the dramatic case of a morbidly obese patient with a well-known difficult airway who was successfully rescued from a cannot ventilate-cannot intubate situation in our critical care unit by using the tracheal esophageal combitube. Surgical tracheostomy was performed while she was mechanically ventilated through the tracheal esophageal combitube. The tracheal esophageal combitube is a very important device that should be kept available in all cases of morbidly obese airway management.