Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2003
Multicenter StudyCognitive dysfunction after minor surgery in the elderly.
Major surgery is frequently associated with postoperative cognitive dysfunction (POCD) in elderly patients. Type of surgery and hospitalization may be important prognostic factors. The aims of the study were to find the incidence and risk factors for POCD in elderly patients undergoing minor surgery. ⋯ Our finding of less cognitive dysfunction in the first postoperative week in elderly patients undergoing minor surgery on an out-patient basis supports a strategy of avoiding hospitalization of older patients when possible.
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Acta Anaesthesiol Scand · Nov 2003
Randomized Controlled Trial Comparative Study Clinical TrialInfluence of total intravenous and inhalational anaesthesia on haemostasis during tympanoplasty.
Surgical trauma leads to systemic changes in haemostasis. Haematological changes activated by surgery may become so prominent that changes caused by anaesthesia might be hidden or underestimated. Therefore, we have undertaken a prospective study to compare the behaviour of selected factors involved in the coagulation and fibrinolytic systems. ⋯ Presuming a minimal traumatic effect of surgical procedure on the determined variables, we conclude that different anaesthetic techniques have a negligible effect on platelet activation and fibrinolysis. The clinical relevance of coagulation activation and fibrinolysis during different anaesthetic techniques remains to be investigated.
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Acta Anaesthesiol Scand · Nov 2003
Randomized Controlled Trial Clinical TrialOndansetron does not prevent pruritus induced by low-dose intrathecal fentanyl.
Addition of an opioid to low-dose spinal anesthesia with bupivacaine improves the quality and success of anesthesia. However, the intrathecal fentanyl-induced pruritus is as high as 75%. We hypothesized that after administration of 4 or 8 mg of prophylactic IV ondansetron, the incidence of pruritus induced by low-dose intrathecal fentanyl would be significantly lower than after placebo. ⋯ After prophylactic administration of 4 or 8 mg of ondansetron IV, the incidence, duration and severity of pruritus were similar to placebo. Ondansetron does not prevent pruritus induced by low-dose intrathecal fentanyl.
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Acta Anaesthesiol Scand · Nov 2003
Clinical TrialHemodynamic effects of a continuous infusion of levosimendan in critically ill patients with cardiogenic shock requiring catecholamines.
Levosimendan, a novel inodilator, has been shown to improve hemodynamic function in patients with decompensated heart failure with preserved arterial blood pressure. Data on its use in patients with cardiogenic shock are rare. The present series describes the 24-h hemodynamic effects of levosimendan as add-on therapy in desperately ill patients with cardiogenic shock requiring catecholamines. ⋯ This series shows that a LS infusion is feasible and able to improve hemodynamics in severely compromized, critically ill patients with cardiogenic shock requiring catecholamine therapy. Its potential advantages when compared with other inotropes are unclear. To clarify the potential role of LS in this clinical setting randomized controlled trials on hemodynamic and mortality endpoints are needed.