Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2007
Randomized Controlled TrialPre-medication with intravenous clonidine suppresses fentanyl-induced cough.
A reflex cough is often observed after an intravenous bolus of fentanyl. This study was conducted to determine whether pre-treatment with intravenous clonidine could effectively attenuate fentanyl-induced cough. ⋯ Pre-treatment with intravenous clonidine (2 microg/kg) suppressed the reflex cough induced by fentanyl, with mild hemodynamic changes. Therefore, intravenous clonidine may be a clinically useful method of suppressing fentanyl-induced cough.
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Acta Anaesthesiol Scand · Aug 2007
Randomized Controlled TrialEffects of hyperoncotic or hypertonic-hyperoncotic solutions on polymorphonuclear neutrophil count, elastase- and superoxide-anion production: a randomized controlled clinical trial in patients undergoing elective coronary artery bypass grafting.
Hypertonic-hyperoncotic solutions may be an effective treatment for systemic inflammatory response syndrome (SIRS). With regard to the immunomodulatory effects of these drugs, previous studies demonstrated controversial results. Therefore, the present study investigated the influence of different hyperoncotic and hypertonic-hyperoncotic solutions on polymorphonuclear neutrophil leukocyte (PMNL) count, elastase and superoxide-anion production in patients undergoing elective coronary artery bypass grafting (CABG) with cardiopulmonary bypass. ⋯ Infusion of clinically relevant doses of hypertonic-hyperoncotic solution did not affect PMNL count, elastase- or superoxide-anion production during elective CABG with cardiopulmonary bypass.
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Transcranial Doppler (TCD) is widely used to investigate the effects of anesthetic drugs on cerebral blood flow. Its repeatability and non-invasivity makes it an ideal, first choice method. Anesthesia providers are required to be conscious of the cerebral hemodynamic effects of drugs given in their practice, especially in neurosurgery and in subjects with impaired brain functions. The purpose of this review is to present the basic concepts of the TCD technique and the effects on cerebral hemodynamics of the most popular anesthetic drugs evaluated using TCD ultrasonography.
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Acta Anaesthesiol Scand · Aug 2007
ReviewAnaesthetic considerations for patients with a pre-existing neurological deficit: are neuraxial techniques safe?
Pre-existing neurological and muscular disease may be a specific concern for anaesthetists as they need to consider the effect of anaesthesia upon the disease, vice versa, and the interaction of anaesthesia with the medication taken by the patient. Despite a lack of controlled studies, many anaesthetists, being afraid of a claim, will prefer general rather than regional anaesthesia in these patients. Nevertheless regional anaesthesia certainly merits its place because it offers undeniable advantages. ⋯ Some diseases may benefit from epidural anaesthesia while for others a spinal technique may be the technique of preference. Special attention should be paid to patients with spinal stenosis despite recent reassuring reports with respect to safety of regional anaesthetic techniques. Anaesthetists should not automatically take all responsibility in case of progressive or new deficit after the procedure.