Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2002
Epidural blood patch for management of postdural puncture headache in adolescents.
In some patients spinal puncture (SP) is followed by postdural puncture headache (PDPH). When the symptoms of PDPH are severe and are not relieved within a few days an epidural blood patch (EBP) might be performed. The aim of this survey was to review requests for EBPs and to evaluate the effectiveness of EBP in patients aged 13-18 years during a 6.5 year period ending in June 2001. ⋯ Epidural blood patch seems to be an effective and safe procedure in adolescents for treating severe and persistent PDPH.
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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 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
Randomized Controlled Trial Clinical TrialNasal CPAP therapy: effects of different CPAP levels on pressure transmission into the trachea and pulmonary oxygen transfer.
Nasal continuous positive airway pressure (nCPAP) is considered useful for prophylaxis and treatment of respiratory complications following major thoracic surgery. It is unknown, however, which CPAP levels are required to avoid alveolar derecruitment and to consistently improve pulmonary oxygen transfer in patients following thoracotomy. We therefore studied the effects of different nCPAP levels on pressure transmission into the trachea as well as on pulmonary oxygen transfer. ⋯ Nasal CPAP is an effective non-invasive means of increasing tracheal and thus intrathoracic pressure without adverse hemodynamic effects. Only mask pressures of 9-10 cm H2O were sufficient to consistently improve pulmonary oxygen transfer in patients following thoracotomy.
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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.