Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2002
Prehospital advanced life support provided by specially trained physicians: is there a benefit in terms of life years gained?
The benefit of prehospital advanced life support (ALS) is disputed, as is the prehospital use of specially trained, hospital-based physicians. The purpose of the study was to assess the health benefit from an anesthesiologist-manned prehospital emergency medical service (EMS), and to separate the benefit of the anesthesiologist from that of rapid transport. ⋯ The expert panels found LYG in every 14th patient assisted by this anesthesiologist-manned prehospital EMS. There was no difference in LYG between the helicopter and the rapid response car missions. The role of the anesthesiologist was crucial for health benefits.
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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 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
Impact factor bias and proposed adjustments for its determination.
The impact factor (IF), a qualitative parameter used to evaluate scientific journals, has several flaws. The aim of the study was to evaluate two of its important constraints, journal self-citation and scientific field, and to investigate the potential for improvement. ⋯ Correcting the IF of the 36 journals for self-citation did not significantly change journal rankings. The adjusted IF/fcat to normalize for the scientific field was positively correlated with the conventional IF.
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Skin conductance (SC) as a measure of emotional state or arousal may be a tool for monitoring surgical stress in anaesthesia. When an outgoing sympathetic nervous burst occurs to the skin, the palmar and plantar sweat glands are filled up, and the SC increases before the sweat is removed and the SC decreases. This creates a SC fluctuation. The purpose of this study was to measure SC during laparoscopic cholecystectomy with propofol and remifentanil anesthaesia and to evaluate whether number and amplitude of SC fluctuations correlate with perioperative stress monitoring. ⋯ Number of SC fluctuations may be a useful method for monitoring the perioperative stress.