Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2010
Randomized Controlled Trial Comparative StudyPerisciatic infusion of ropivacaine and analgesia after hallux valgus repair.
Moderate to severe pain after hallux valgus repair can be successfully treated with a continuous popliteal sciatic nerve block in ambulatory patients. Different anesthesiologists use various infusion rates for this purpose. The aim of this study was to compare the analgesic efficacy of two infusion rates of ropivacaine 2 mg/ml: 5 and 8 ml/h. ⋯ We found no significant difference in the analgesic effect between two perisciatic infusion rates of ropivacaine 2 mg/ml (5 vs. 8 ml/h) in ambulatory patients who underwent chevron osteotomy.
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Acta Anaesthesiol Scand · Nov 2010
Randomized Controlled TrialHuman opioid μ-receptor A118G polymorphism may protect against central pruritus by epidural morphine for post-cesarean analgesia.
Intrathecal or epidural morphine used for post-operative analgesia frequently induces central type pruritus. The purpose of this study was to investigate the association between the severity of central type pruritus induced by epidural morphine for post-cesarean analgesia and the A118G polymorphism of the human μ-opioid receptor gene (OPRM1). ⋯ The incidence of significant pruritus in the recessive type (GG) was significantly lower compared with the dominant types (AA+AG). The recessive G allele in the A118G polymorphism may have protective effects against significant pruritus after epidural morphine for post-cesarean analgesia.
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Acta Anaesthesiol Scand · Nov 2010
The effect of a simple checklist on frequent pre-induction deficiencies.
A substantial proportion of anaesthesia-related adverse events are preventable by identification and correction of errors in planning, communication, fatigue, stress, and equipment. The aim of this study was to develop and implement a pre-induction checklist in order to identify and solve problems before induction of anaesthesia. ⋯ It is possible to develop, introduce, and use a pre-induction checklist even in a hectic and stressful clinical environment. The checklist identified and reduced a surprisingly large number of missing items required in a standard induction protocol.
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Acta Anaesthesiol Scand · Nov 2010
Spontaneous breathing during high-frequency oscillatory ventilation improves regional lung characteristics in experimental lung injury.
Maintenance of spontaneous breathing is advocated in mechanical ventilation. This study evaluates the effect of spontaneous breathing on regional lung characteristics during high-frequency oscillatory (HFO) ventilation in an animal model of mild lung injury. ⋯ This animal study demonstrates that spontaneous breathing during HFO ventilation preserves lung volume, and when combined with DF, improves ventilation of the dependent lung areas. No significant hyperinflation occurred on account of spontaneous breathing. These results underline the importance of maintaining spontaneous breathing during HFO ventilation and support efforts to optimize HFO ventilators to facilitate patients' spontaneous breathing.
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Acta Anaesthesiol Scand · Nov 2010
Pulmonary haemodynamics and right ventricular function during cemented hemiarthroplasty for femoral neck fracture.
Bone cement implantation syndrome (BCIS) is characterised by hypoxia, hypotension and loss of consciousness occurring early after bone cementation. The haemodynamic perturbations during BCIS have not been extensively studied, particularly not in patients with femoral neck fracture. We evaluated the effects of cemented hemiarthroplasty, in these patients, on pulmonary haemodynamics, right ventricular performance, intrapulmonary shunting and physiological dead space. ⋯ Cemented hemiarthroplasty in patients with femoral neck fracture causes a pronounced pulmonary vasoconstriction and an impairment of RV function accompanied by pulmonary ventilation/perfusion abnormalities.