Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2003
Case ReportsFunctional improvement after physiotherapy with a continuous infusion of local anaesthetics in patients with complex regional pain syndrome.
Three patients were referred to our pain clinic with evidence of complex regional pain syndrome in their extremities. Two presented at the atrophic stage with joint contractures. Multiple analgesics had been prescribed without long-lasting relief. ⋯ We instituted local anaesthetic infusion with the possibility of self-supplementation to facilitate physiotherapy; two via brachial plexus catheters for hand pain and one via epidural catheter for knee pain. Although their resultant pain scores were variable after cessation of local anaesthetic infusion, all the affected joints exhibited marked improvement in range of movement. We propose that this technique is a useful option for patients in all stages of complex regional pain syndrome where the emphasis is now directed toward functional improvement.
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Acta Anaesthesiol Scand · Nov 2003
Positioning internal jugular venous catheters using the right third intercostal space in children.
Central venous catheters are used for pressure measurement, and drug and fluid therapy in children. Several reports have described serious complications related to catheter positioning. We evaluated the possibility of using the right third intercostal space as an anatomic landmark for determining the optimal insertion depth of a central venous catheter from the right internal jugular vein. ⋯ Using the right third intercostal space as an anatomic landmark allows positioning of the catheter tip in the SVC near to but not in the RA in children.
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Acta Anaesthesiol Scand · Feb 2003
Effects of human cathelicidin antimicrobial peptide LL-37 on lipopolysaccharide-induced nitric oxide release from rat aorta in vitro.
Lipopolysaccharides (LPS), released by Gram-negative bacteria, cause vascular expression of inducible nitric oxide synthase (iNOS) leading to nitric oxide (NO) production and septic shock. Human cathelicidin antimicrobial peptide (LL-37) can bind and neutralize LPS. We wanted to study whether LL-37 affects LPS or interleukin-1beta (IL-1beta)-induced production, release and function of NO in intact rat aorta rings and cultured rat aorta smooth muscle cells. ⋯ IL-37 reduces NO production induced by LPS and IL-1beta. The reduction does not seem to result only from neutralization of LPS but also from a cytotoxic effect, possibly via induction of apoptosis.
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Acta Anaesthesiol Scand · Oct 2003
Xenon incorporated in a lipid emulsion inhibits NMDA receptor channels.
Over the past decade hyperpolarized (129)xenon incorporated in lipid emulsions has been studied for the purpose of imaging enhancement in radiology. Xenon (Xe), a NMDA (N-methyl-D-aspartate)-receptor antagonist, has neuroprotective properties even at subanesthetic concentrations. Thus, its intravenous administration for this purpose deserves further evaluation. In this study, we investigated in an in vitro model the effect of Xe, incorporated in a lipid emulsion (Lipofundin MCT(R) 20%), on the NMDA receptor channel of cortical neurons of the mouse. ⋯ The data demonstrate that Xe dissolved in Lipofundin MCT(R) 20% inhibits NMDA-receptors. Lipid emulsions enriched with Xe may serve as a carrier and a reservoir for Xe.
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Acta Anaesthesiol Scand · May 2003
Case ReportsA fatal case of malignant hyperthermia complicated by generalized compartment syndrome and rhabdomyolysis.
A healthy 21-year-old male who had previously been anaesthetized without complications underwent a laparotomy following a skiing accident. He developed severe malignant hyperthermia. ⋯ The patient died of hyperkalaemia in spite of continuous dialysis. We present a detailed description of the case and also discuss the role of propofol and rhabdomyolysis.