Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2003
Randomized Controlled Trial Clinical TrialClinical trial of esmolol-induced controlled hypotension with or without acute normovolemic hemodilution in spinal surgery.
Drug-induced controlled hypotension (CH) combined with acute normovolemic hemodilution (ANH) is being widely used for blood conservation in surgical patients. The purpose of this study was to investigate the efficacy and safety of esmolol-induced CH combined with ANH (hematocrit down to 28%). ⋯ Our data suggest that ANH of moderate degree can be combined with esmolol-induced CH to improve blood conservation in surgical patients.
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Acta Anaesthesiol Scand · Jan 2003
Comparative StudyComparison of forced-air warming systems with lower body blankets using a copper manikin of the human body.
Forced-air warming has gained high acceptance as a measure for the prevention of intraoperative hypothermia. However, data on heat transfer with lower body blankets are not yet available. This study was conducted to determine the heat transfer efficacy of six complete lower body warming systems. ⋯ No relevant differences in heat transfer of lower body blankets were found between the different forced-air warming systems tested. Heat transfer was lower than heat transfer by upper body blankets tested in a previous study. However, forced-air warming systems with lower body blankets are still more effective than forced-air warming systems with upper body blankets in the prevention of perioperative hypothermia, because they cover a larger area of the body surface.
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Acta Anaesthesiol Scand · Apr 2003
Comparative StudyPain relief and safety after major surgery. A prospective study of epidural and intravenous analgesia in 2696 patients.
Adverse effects may still limit the use of continuous epidural and intravenous analgesia in surgical wards. This study postulated that postoperative epidural analgesia was more efficient, and had fewer side-effects than intravenous morphine. The aim was to investigate efficacy, adverse effects and safety of the treatments in a large patient population. ⋯ In a large patient population the use of epidural and intravenous postoperative analgesia was considered safe in surgical wards, and the incidence of adverse effects was low. Patients with epidural analgesia experienced overall less pain, while opioid related side-effects were more common with intravenous morphine analgesia.
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Acta Anaesthesiol Scand · Apr 2003
Clinical TrialPost-thoracotomy pain after thoracic epidural analgesia: a prospective follow-up study.
Pain becomes chronic in 22-67% of patients who undergo a thoracotomy. Thoracic epidural analgesia (TEA) has replaced less invasive methods to manage postoperative pain. We wanted to find out if active use of TEA, combined with extended pain management at home, reduces the incidence of chronic post-thoracotomy pain. ⋯ TEA seems effective in controlling evoked postoperative pain, but technical problems occurred in 24% of the epidural catheters. The incidence of chronic pain was lower compared with previous studies where TEA was not used. The patients had significant pain and needed regular pain medication and instructions during the first week after discharge. Extended postoperative analgesia up to the first week at home is warranted.
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Acta Anaesthesiol Scand · Jul 2003
Clinical TrialInfluences on serum concentrations of morphine, M6G and M3G during routine clinical drug monitoring: a prospective survey in 300 adult cancer patients.
In order to make treatment decisions physicians should have knowledge about the relations between patient characteristics and drug disposition. Dose, route of administration, gender, age and renal function are reported to influence the serum concentrations of morphine, morphine-6-glucurnide (M6G) and morphine-3-glucuronide (M3G) during chronic treatment of cancer pain. These factors, however, are not evaluated in studies with a sample size sufficient to explore predictive factors. ⋯ Patient characteristics predict only minor parts of the variability of morphine, M3G and M6G serum concentrations observed during routine clinical drug-monitoring in cancer patients.