Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 2003
Randomized Controlled Trial Comparative Study Clinical TrialPCEA compared to continuous epidural infusion in an ultra-low-dose regimen for labor pain relief: a randomized study.
Patient-controlled epidural analgesia, PCEA, has been introduced in obstetric analgesia during the past decade. Many studies have shown that the consumption of analgesic is reduced when the parturient requests her own doses. This study investigates whether this is also true when using an ultra-low-dose regimen. ⋯ PCEA reduces doses compared to continuous infusion even when ultra-low-dose local anesthetic with opioid is used. The PCEA technique provides individual titration of doses to an acceptable degree of pain relief.
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Acta Anaesthesiol Scand · Oct 2003
Randomized Controlled Trial Clinical TrialEpinephrine added to a lumbar epidural infusion of a small-dose ropivacaine-fentanyl mixture after arterial bypass surgery of the lower extremities.
The addition of epinephrine (2 micro g.ml-1) to a thoracic epidural infusion of an opioid-local anesthetic mixture improves analgesia. Here, we studied whether epinephrine could improve analgesia also at lumbar level, when added to an epidural infusion of a low-dose ropivacaine-fentanyl mixture after arterial bypass surgery of the legs. ⋯ In the dosage used here, epinephrine did not improve epidural lumbar analgesia. Different distances from the epidural application site to the alpha2-adrenergic receptors of the spinal cord, and differing epinephrine dose requirements may explain why epinephrine as an additive improves epidural analgesia at thoracic, but not at lumbar level.
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Acta Anaesthesiol Scand · Oct 2003
Randomized Controlled Trial Clinical TrialDifferences among forced-air warming systems with upper body blankets are small. A randomized trial for heat transfer in volunteers.
Forced-air warming is known as an effective procedure in prevention and treatment of perioperative hypothermia. Significant differences have been described between forced-air warming systems in combination with full body blankets. We investigated four forced-air warming systems in combination with upper body blankets for existing differences in heat transfer. ⋯ Based on an estimated heat loss from the covered area of 38 W the heat balance is changed by 46.1 W to 55 W by forced-air warming systems with upper body blankets. Although the differences in heat transfer are significant, the clinical relevance of this difference is small.
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Acta Anaesthesiol Scand · Oct 2003
Randomized Controlled Trial Clinical TrialEquivalence of hydroxyethyl starch HES 130/0. 4 and HES 200/0. 5 for perioperative volume replacement in major gynaecological surgery.
Hydroxyethyl starch solutions (HES) are increasingly used for the compensation of surgical blood loss. The objective of this clinical trial was to compare a novel 6% HES 130/0.4 solution with a favourable pharmacological profile and a standard 6% HES 200/0.5 solution for maintenance of haemodynamic stability in major gynaecological surgery. ⋯ This clinical trial demonstrated therapeutic equivalence of this novel low-substituted HES 130/0.4 solution and a standard HES 200/0.5 solution for perioperative volume replacement. Moreover, both HES preparations were equally well-tolerated and safe.