Acta anaesthesiologica Scandinavica
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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.
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The laryngeal tube has a potential role during anaesthesia, but there have been only a few studies assessing its efficacy during the entire course of anaesthesia, and all previous studies used prototypes. We studied 100 patients to assess the efficacy of a new laryngeal tube during the entire course of anaesthesia. ⋯ The laryngeal tube can be useful for maintaining a patent airway during anaesthesia.
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Acta Anaesthesiol Scand · Aug 2003
Randomized Controlled Trial Comparative Study Clinical TrialContinuous spinal anesthesia/analgesia vs. single-shot spinal anesthesia with patient-controlled analgesia for elective hip arthroplasty.
In total hip replacement surgery several anesthesiological techniques can be used. In this study we compared continuous spinal anesthesia (CSA) and postoperative analgesia vs. single-shot spinal anesthesia (SPA) and postoperative patient-controlled intravenous analgesia with morphine (SPA). ⋯ Continuous spinal anesthesia/analgesia is a very practicable method providing better postoperative analgesia and better hemodynamic stability during anesthesia induction than SPA followed by morphine PCA analgesia after total hip replacement surgery.
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Acta Anaesthesiol Scand · Aug 2003
Randomized Controlled Trial Comparative Study Clinical TrialComparison of different concentrations of levobupivacaine for post-operative epidural analgesia.
The relative effects of the mass, volume and concentration of local anaesthetic solution used for epidural anaesthesia and analgesia are still under debate. Clinical studies have shown discrepancies, probably because of limited consideration of total dose. ⋯ The same dose of levobupivacaine provides an equal quality of analgesia in low or high volume continuous thoracic epidural infusion with reduced haemodynamic instability and nausea in the low volume/high concentration groups.
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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.