Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2003
Performance of the rapidly extracted auditory evoked potentials index to detect the recovery and loss of wakefulness in anesthetized and paralyzed patients.
The rapidly extracted auditory evoked potentials index (A-lineTM ARX Index or AAI) has been proposed as a method to measure the depth of anesthesia. A prospective study was designed to assess the performance of AAI to detect the recovery and loss of wakefulness in anesthetized and paralyzed patients. ⋯ The AAI may be a good predictor of recovery and loss of wakefulness for anesthetized and paralyzed patients.
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Acta Anaesthesiol Scand · May 2003
Clinical TrialRocuronium and cisatracurium-positive skin tests in non-allergic volunteers: determination of drug concentration thresholds using a dilution titration technique.
Muscle relaxants are believed to be responsible for 2/3 of the cases of anaphylactic reactions during anesthesia. This assumption is based mainly on positive skin tests obtained in individuals that have experienced anesthesia-related anaphylaxis. A positive skin test is supposed to be associated with mast cell degranulation of vasoactive amines. In the present study we tested the frequency of positive skin tests with two commonly used muscle relaxants, rocuronium and cisatracurium, in a selected group of volunteers with low potential for allergic reactions. ⋯ Non-mast-cell-mediated positive intradermal skin reactions are frequently occurring with rocuronium and cisatracurium, even at vial dilution 1 : 1000. A clinically applicable test technique is needed that is able to separate positive skin tests associated with mast cell degranulation from non-mast-cell-mediated reactions.
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Acta Anaesthesiol Scand · Feb 2003
Anesthesiologists in prehospital care make a difference to certain groups of patients.
Knowledge of the population using prehospital emergency services is scarce except for selected subgroups. Interventions are often made without evaluation. The aim of this study was (1) to describe mortality, hospitalization and the diagnostic pattern among emergency ambulance users and (2) to evaluate the impact of one mobile emergency care unit (MECU) staffed by an anesthesiologist. ⋯ The diagnostic pattern among emergency ambulance users included all main groups of diseases. After the MECU fewer were brought to hospital. The overall mortality for all ambulance users was not influenced by the MECU. For the subgroups, especially AMI, mortality was lower after the introduction of the MECU.
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Acta Anaesthesiol Scand · Oct 2003
Pancuronium bromide, a non-depolarizing muscle relaxant which promotes apoptosis of blood lymphocytes in vitro.
Several compounds used in anesthesia practice have demonstrated to impair immune function and to influence the process of apoptotic death in T cell population following surgical trauma. We designed this study to test in vitro the impact of neuromuscular blocker, such as pancuronium, at clinically relevant concentration on lymphocyte apoptosis, death factor expression and mitochondrial function. ⋯ Our data suggest an apoptogenic effect of pancuronium in vitro at clinically relevant concentration on peripheral blood lymphocytes. This could be implicated in the transient immune suppression following a surgical operation.
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Acta Anaesthesiol Scand · Mar 2003
Case ReportsNitrous oxide anesthesia and intravitreal gastamponade.
The right eye of a 66-year-old man was operated with vitrectomy and peeling of an epiretinal membrane. Perioperatively, the eye was filled with 20% SF6 gas to tamponade retinal breaks. Five days later the patient underwent prostatectomy under general anesthesia using nitrous oxide. ⋯ The movement of nitrous oxide into gas-containing spaces in the body has been known for a long time. The use of nitrous oxide in patients with intravitreal gas will elevate the intraocular pressure with risk for closure of the central retinal artery. The present case report highlights the problems that can occur when preoperative assessment is carried out a long time before surgery.