Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2009
Multicenter Study Clinical TrialThe incidence of intra-operative awareness during general anesthesia in China: a multi-center observational study.
The incidence of awareness in patients undergoing general anesthesia is 0.1-0.2% in Western countries. The medical literatures about awareness during general anesthesia are still rare in China, but some previous studies have reported a higher incidence (1.4-6%) of intra-operative awareness. To find out the reason why the incidence reported in China is much higher than that in Western countries, we performed a prospective, multicenter, non-randomized observational study to determine the true incidence of intra-operative awareness in China. ⋯ The incidence of intra-operative awareness in China is approximately 0.41%, two to three times higher than that widely cited in Western countries. Inappropriately light anesthesia, and the population proportion of surgery and general anesthesia in China may account for the difference. (ClinicalTrials.gov Identifier, NCT00693875.).
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Acta Anaesthesiol Scand · Aug 2009
Case ReportsCombining the EndoFlex tube with fiberoptic bronchoscopy in difficult intubation.
We applied a combination technique using the EndoFlex tube with fiberoptic bronchoscopy for a 69-year-old man presenting with limited mouth opening and neck movement. Awake nasotracheal intubation was performed under conscious sedation with propofol and fentanyl. ⋯ Fiberoptic visualization confirmed that the distal-tip flexing mechanism of the EndoFlex tube corrected the direction of the tube tip anteriorly, allowing entry into the trachea. We present a case where this technique proved valuable for tracheal intubation in a patient with limitations of mouth opening and neck movement.
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Acta Anaesthesiol Scand · Aug 2009
Randomized Controlled TrialKetamine attenuates post-operative cognitive dysfunction after cardiac surgery.
Post-operative cognitive dysfunction (POCD) commonly occurs after cardiac surgery. Ketamine exerts neuroprotective effects after cerebral ischemia by anti-excitotoxic and anti-inflammatory mechanisms. We hypothesized that ketamine attenuates POCD in patients undergoing cardiac surgery concomitant with an anti-inflammatory effect. ⋯ Ketamine attenuates POCD 1 week after cardiac surgery and this effect may be related to the anti-inflammatory action of the drug.
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Acta Anaesthesiol Scand · Aug 2009
Randomized Controlled Trial Comparative StudyA new supraglottic airway device: LMA-supreme, comparison with LMA-Proseal.
The LMA-Supreme() (S-LMA()) is a new supraglottic airway device that presents combined features of flexibility, curved structure and single use and a different cuff structure. The purpose of this study was to compare the oropharyngeal leak pressures (OLP) of LMA-Proseal() (P-LMA()) and S-LMA(). ⋯ Our findings suggest that S-LMA() had leak pressures similar to the P-LMA(), and this new airway device proved to be successful during both spontaneous and positive pressure ventilation.
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Acta Anaesthesiol Scand · Aug 2009
Anti-ischemic effects of inotropic agents in experimental right ventricular infarction.
Right ventricular (RV) function is an important determinant of survival after myocardial infarction. The efficacy of reperfusion therapy might be increased by the cardioprotective action of inotropic agents, which are used for symptomatic therapy in situations with compromised hemodynamics. Therefore, we used a porcine model of RV ischemia and reperfusion (IR) injury to study the influence of milrinone, levosimendan and dobutamine on the extent and degree of myocardial injury. ⋯ Cardioprotective properties of milrinone and levosimendan were demonstrated for the first time in a clinically relevant model of RV infarction.