Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2005
Randomized Controlled TrialLocal anesthesia for functional endoscopic sinus surgery employing small volumes of epinephrine-containing solutions of lidocaine produces profound hypotension.
Local anesthetic containing epinephrine is commonly used in many operations for the main purpose of hemostasis. A randomized, controlled, prospective clinical trial was designed to find out hemodynamic changes after local infiltration of different concentrations and/or different dosages of epinephrine during functional endoscopic sinus surgery (FESS) under general anesthesia. ⋯ Local infiltration of low-dose epinephrine causes temporary significant hemodynamic changes particularly a marked decrease in BP during FESS under general anesthesia.
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Acta Anaesthesiol Scand · Nov 2005
Randomized Controlled Trial Comparative StudyComparison of the effect of ketamine added to bupivacaine and ropivacaine, on stress hormone levels and the duration of caudal analgesia.
The aim of this study was to compare bupivacaine 0.25% and ropivacaine 0.2%, singly and in combination with ketamine, for caudal administration in children. Duration of analgesia, the need for other analgesics and the stress response were measured. ⋯ Ketamine can safely be added to ropivacaine 0.2% or bupivacaine 0.25% for caudal anesthesia in order to prolong duration of analgesia and reduce the need for additional analgesics. Stress hormone levels are partially attenuated.
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Acta Anaesthesiol Scand · Nov 2005
Randomized Controlled Trial Comparative StudyIntrathecal clonidine does not reduce post-spinal shivering.
After general or epidural anesthesia, clonidine is known to be effective in suppressing established shivering. The aim of this study was to assess the preventive effect of intrathecal clonidine on post-spinal shivering compared with intravenous (i.v.) clonidine. ⋯ The intrathecal administration of clonidine 150 microg fails to prevent post-spinal shivering; by contrast, we have confirmed that i.v. clonidine 1 microg/kg is an effective method to prevent shivering in patients undergoing spinal anesthesia for orthopedic surgery.
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Acta Anaesthesiol Scand · Nov 2005
Randomized Controlled TrialInfluence of orientations of guidewire tip on the placement of subclavian venous catheters.
The role of a J-type guidewire tip has been known to prevent vascular or cardiac wall damage. We hypothesized that the course of the guidewire may be influenced by the initial orientations of the J-type guidewire tip during the subclavian approach. The purpose of this study was to investigate the influence of the direction of the needle bevel and J-wire tip on successful placement of subclavian catheters. ⋯ These data suggest that the orientation of the J-wire tip downward can increase successful placement rates of right subclavian venous catheterization.
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Acta Anaesthesiol Scand · Nov 2005
Improved survival after in-hospital cardiac arrest outside critical care areas.
The in-hospital Utstein Guidelines may be used to evaluate resuscitation strategies. This study utilized the Utstein template prospectively to examine changes in outcome and outcome-related factors after resuscitation outside critical care areas over a 10-year period. ⋯ Prospective Utstein style data collection proved to be a valuable tool for the evaluation of management and outcome following in-hospital cardiac arrest. Increased survival was seen over 10 years outside critical care areas. Organizational changes, including cardiopulmonary resuscitation training for ward personnel and standardized resuscitation management, may have contributed to this change.