Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2005
Comparative StudyPosterior labat vs. lateral popliteal sciatic block: posterior sciatic block has quicker onset and shorter duration of anaesthesia.
During foot and ankle surgery, a combination of a sciatic and femoral nerve block is a well-recognized technique for providing anaesthesia and post-operative analgesia. Our hypothesis is that the posterior gluteal sciatic block (PSB) is more efficient than the lateral popliteal sciatic block (LPSB), and this study compared the anaesthetic characteristics between these two techniques performed for elective ankle and foot surgery. ⋯ PSB is easier to perform, and has a quicker onset of sensory blockade whereas LPSB has a longer duration of analgesia.
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Acta Anaesthesiol Scand · May 2005
Plasma concentrations of meperidine and normeperidine following continuous intrathecal meperidine in patients with neuropathic cancer pain.
Intrathecal administration of meperidine, an opioid with local anesthetic activity, can induce analgesia in patients with intractable cancer pain. However, continuous intrathecal administration may result in the accumulation of normeperidine, responsible for central nervous system toxicity. ⋯ We conclude that continuous intrathecal administration of meperidine alone, or in combination with clonidine, can provide significant pain relief in patients with poor pain control despite pharmacological treatment. However, accumulation of meperidine and normeperidine resulting in central nervous system toxicity may occur during this treatment.
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Acta Anaesthesiol Scand · May 2005
Review Meta Analysis Comparative StudyEffect of preoperative Cox-II-selective NSAIDs (coxibs) on postoperative outcomes: a systematic review of randomized studies.
Preoperative use of coxibs has been claimed to reduce postoperative pain and analgesic consumption, and to affect other postoperative outcomes. ⋯ Preoperative coxibs had clear benefits in terms of reduced postoperative pain, analgesic consumption and patient satisfaction compared with placebo. Effects on postoperative nausea and vomiting remain uncertain, as do those on recovery from surgery or economic benefit. Future trials should be larger and more pragmatic in nature.
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Acta Anaesthesiol Scand · May 2005
Randomized Controlled Trial Clinical TrialA-line autoregression index monitoring to titrate inhalational anaesthesia: effects on sevoflurane consumption, emergence time and memory.
A-line autoregression index (AAI) is a parameter derived from auditory evoked potentials proposed as depth of anaesthesia monitor. We evaluated the effects of AAI guidance on sevoflurane consumption, emergence time, explicit and implicit memory. ⋯ AAI titration of anaesthesia allows a significant reduction in sevoflurane consumption and emergence time without significant effects on the incidence of explicit and implicit memory. Nevertheless the relationship between AAI and memory requires studies in larger groups of patients.
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Acta Anaesthesiol Scand · May 2005
Observations and warning signs prior to cardiac arrest. Should a medical emergency team intervene earlier?
The Medical Emergency Team (MET) has evolved in some hospitals as a means of delivering effective treatment early enough to prevent cardiac arrests. Our aim was to analyze the effectiveness of observation practice to detect abnormalities in vital signs prior to cardiac arrest and to determine the need for a MET system in Finnish hospitals. ⋯ Significant physiological deterioration seems to be common in the hours before a cardiac arrest on the wards of Finnish hospitals, suggesting that implementation of a MET-system may be worthwhile. However, the practice of vital sign observation by the nursing staff should be improved before maximal benefit of a MET can be achieved.