Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2003
Influence of the cortical electrical activity level during general anaesthesia on the severity of immediate postoperative pain in the morbidly obese.
The objective of anaesthesia is to provide hypnosis, analgesia and adequate conditions during surgery. It is difficult to establish the appropriate dose of general anaesthetic drugs in the morbidly obese patient. Moreover, there are conflicting data concerning adequate anaesthesia levels and the severity of postoperative pain. The aim of this study was to investigate the relationship between the spectral edge frequency (SEF) during general anaesthesia and the severity of immediate postoperative pain following gastric banding surgery in morbidly obese patients. ⋯ Keeping the SEF range between 8 and 12 Hz during anaesthesia for laparoscopic gastric banding for morbid obesity, both the immediate post operative pain intensity and morphine requirement, are significantly reduced.
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Acta Anaesthesiol Scand · Aug 2003
Comparative StudyComparison of transcutaneous and endtidal CO2-monitoring for rigid bronchoscopy during high-frequency jet ventilation.
To compare endtidal and transcutaneous respiratory monitoring of high-frequency jet ventilation (HFJV) in rigid bronchoscopy. Both techniques provide a noninvasive measurement of pCO2. ⋯ Endtidal capnography offers accurate respiratory monitoring of HFJV. Transcutaneous monitoring showed a good correlation to ABG only during steady-state conditions. For the dynamic phase the accuracy was significantly lower. Thus, we cannot recommend transcutaneous respiratory monitoring for the specific indication of rigid bronchoscopy using HFJV.
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Acta Anaesthesiol Scand · Aug 2003
Randomized Controlled Trial Clinical TrialAbsence of explicit and implicit memory in unconscious patients using a TCI of propofol.
Episodes of implicit memory have been described during propofol anaesthesia. It remains unclear whether implicit memory is caused by short periods of awareness or occurs in an unconscious subject. ⋯ In our group of young ASA I/II patients, in the absence of any noxious stimulus, no implicit or explicit memory was found when the calculated concentration of propofol using a Diprifusor was maintained at the level associated with LOC.
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Acta Anaesthesiol Scand · Aug 2003
Randomized Controlled Trial Clinical TrialThe effectiveness of intravenous ketamine and lidocaine on peripheral neuropathic pain.
Neuropathic pain is often severe and resistant to pharmacological treatment. The aims of the present study were to assess the analgesic effect of ketamine and lidocaine and to investigate if measurement of different variables of sensibility could be used to identify responders. We also wanted to study if treatment resulted in changes of sensibility. ⋯ Ketamine showed a significant analgesic effect. The clinical usefulness is, however, limited by disturbing side-effects.
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Acta Anaesthesiol Scand · Aug 2003
Case ReportsLow utilisation of unactivated protein C in a patient with meningococcal septic shock and disseminated intravascular coagulation.
Activated protein C has recently been shown in a multicentre trial to significantly reduce mortality in patients with septic shock. There are also some case reports and minor studies demonstrating promising results with the unactivated form of protein C. However, in children with severe meningococcal infection, skin biopsies have demonstrated low expression of endothelial thrombomodulin and protein C receptors, suggesting low protein C activation capacity in severe meningococcal sepsis. ⋯ The result indicates that whole body utilisation of the unactivated protein C was low. Endothelial impairment of protein C activation does not seem to be restricted to the skin vessels only.