Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 2003
Clinical TrialPreoperative emotional states in patients with breast cancer and postoperative pain.
The present study examined the relationship between psychological variables, including anxiety, depression, and patient-controlled analgesia (PCA) use in patients who underwent radical mastectomy. ⋯ Patients with higher anxiety and depression levels had higher postoperative pain and analgesic requirements in this study.
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Acta Anaesthesiol Scand · Jan 2003
Clinical TrialDecrease in the incidence of post-dural puncture headache: maintaining CSF volume.
The incidence of epidural needle-induced post-dural puncture headache (PDPH) in parturients following dural puncture with a large bore (18-gauge) needle has been reported to range 76-85%. We describe seven cases in which the performance of epidural anesthesia in parturients was complicated by an unintentional dural puncture with an 18-gauge epidural needle. In all seven cases, the unintentional dural puncture was followed by (i) injection of the CSF in the glass syringe back into the subarachnoid space through the epidural needle, (ii) insertion of a epidural catheter into the subarachnoid space (now referred to as an intrathecal catheter), (iii) injection of a small amount of preservative free saline (3-5 ml) into the subarachnoid space through the intrathecal catheter, (iv) administration of bolus and then continuous intrathecal labor analgesia through the intrathecal catheter and then (v) leaving the intrathecal catheter in-situ for a total of 12-20 h. PDPH occurred in only one of these cases (14%).
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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 · Jan 2003
Effects of acute normovolemic hemodilution on ventriculoarterial coupling in dogs.
Acute normovolemic hemodilution (ANH) causes a decrease in systemic vascular resistance. Similar to vasodilating drugs, ANH might modify ventriculoarterial coupling. Left ventricular elastance (Ees), effective arterial elastance (Ea), stroke work (SW), and pressure volume area (PVA) were used as indicators to examine the effects of ANH on this coupling. ⋯ Before ANH, ventriculoarterial coupling was so matched as to maximize SW at the expense of the work efficiency. This relation was preserved at ANH50.