Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2007
Case ReportsCarbon dioxide and argon gas embolism during laparoscopic hepatic resection.
During laparoscopic hepatic resection, an abrupt decrease in FE'CO(2) (from 28 mmHg to 9 mmHg) associated with near cardiac arrest occurred concomitantly with hepatic vein laceration and the use of an argon beam coagulator system. During venous gas embolism, transesophageal echocardiography (TEE) proved the transpulmonary passage of the gas. In the post-operative period, the patient developed pulmonary edema and made a full recovery after 5 days. This is a case report of a possible paradoxic carbon dioxide (CO(2)) and argon gas embolism by transpulmonary passage during laparoscopic hepatic resection.
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Acta Anaesthesiol Scand · Aug 2007
Job satisfaction, work ability and life satisfaction among Finnish anaesthesiologists.
Organizational changes and relative growth of the ageing population together with related health problems seem to have increased stressfulness in the work of anaesthesiologists. However, little is known about their work-related well-being and the factors through which their situation could be improved. ⋯ Job control and organizational justice were the most important determinants in work-related well-being. Work-related factors were slightly more important correlates of well-being in males, and family life seems to play a larger role in the well-being of female anaesthesiologists. Organizational and gender issues need to be addressed in order to maintain a high level of well-being among anaesthesiologists.
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Acta Anaesthesiol Scand · Aug 2007
Clinical TrialAn open non-randomized study of recombinant activated factor VII in major postpartum haemorrhage.
Empirical off-label use of recombinant activated factor VII (rFVIIa) has been reported to be effective in some cases of severe postpartum haemorrhage (PPH). Successful management of these patients has lead to more wide-spread use of rFVIIa in less severe cases without any evidence for the advantages of its administration. ⋯ The decision to use rFVIIa resulted from a more profound haemorrhage. We did not gain any evidence to extend the use of rFVIIa into less severe cases of PPH. Furthermore, this policy would result in a profound increase in the overall costs of the treatment. Randomized placebo-controlled trials are urgently needed to optimize the use of rFVIIa in obstetric haemorrhage.
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Acta Anaesthesiol Scand · Aug 2007
Who is responsible for operating room management and how do we measure how well we do it?
Managing the surgical process in the operating suite - often the most expensive unit in the hospital - is vital, yet challenging. While sensible management can improve efficiency, unclear managerial structures can hinder the optimal use of resources. Despite that, no previous data exists as to how the operating room management is organized and the performance monitored in our country. ⋯ The structure of the daily operative management of an operating room needs redefining. There should be more focus on collaboration and communication between the care providers.
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Acta Anaesthesiol Scand · Aug 2007
Ultrasound controlled nerve stimulation in the elbow region: high currents and short distances needed to obtain motor responses.
Electrical nerve stimulation is commonly used to perform peripheral nerve blocks. The purpose of this study was to investigate the relation between stimulating currents and the distance between the needle-tip and stimulated nerves. ⋯ Our results show significant differences in the ease of stimulation between the radial and ulnar nerves. High current thresholds and short nerve-to-needle distances were often needed to obtain neuromuscular responses in two nerves in the elbow region.