Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2010
Randomized Controlled Trial Comparative StudyProcedural pain of an ultrasound-guided brachial plexus block: a comparison of axillary and infraclavicular approaches.
Ultrasound (US)-guided infraclavicular (IC) and axillary (AX) blocks have similar effectiveness. Therefore, limiting procedural pain may help to choose a standard approach. The primary aims of this randomized study were to assess patient's pain during the block and to recognize its cause. ⋯ We did not find significant differences between the two approaches in procedural pain and patient's acceptance. The choice of approach may depend on the anaesthesiologist's experience and the patient's preferences.
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Acta Anaesthesiol Scand · Apr 2010
Randomized Controlled TrialInfusion of hypertonic saline/starch during cardiopulmonary bypass reduces fluid overload and may impact cardiac function.
Peri-operative fluid accumulation resulting in myocardial and pulmonary tissue edema is one possible mechanism behind post-operative cardiopulmonary dysfunction. This study aimed to confirm an improvement of cardiopulmonary function by reducing fluid loading during an open-heart surgery. ⋯ An intraoperative infusion of HSH during cardiac surgery contributes to reduced fluid loading and an improvement in the post-operative cardiac performance. No adverse effects of the HSH infusion were observed.
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Acta Anaesthesiol Scand · Apr 2010
Impact of the post-World War II generation on intensive care needs in Norway.
A high birth rate during the first two decades following World War II has increased the proportion of elderly people in present-day society and, consequently, the demand for health-care services. The impact on intensive care services may become dramatic because the age distribution of critically ill patients is skewed towards the elderly. We have used registry data and population statistics to forecast the demand for intensive care services in Norway up until the year 2025. ⋯ The demand for intensive care beds will increase markedly in Norwegian hospitals in the near future. This will have serious implications for the planning of infrastructure, education of health care personnel, as well as financing of our health care system.
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Caffeine is a natural alkaloid methylxanthine that is found in various plants such as coffee or tea. Symptoms of a severe overdose may present with hypokalemia, hyponatremia, ventricular arrhythmias, hypertension followed by hypotension, respiratory failure, seizures, rhabdomyolysis, ventricular fibrillation and finally circulatory collapse. A 21-year-old woman called for the ambulance herself soon after the ingestion of about 10,000 mg of caffeine. ⋯ Furthermore, it may be beneficial to replace the potassium as early as possible. Epinephrine and buffer solutions used during resuscitation may further decrease blood potassium levels and should be administrated cautiously. Epinephrine can be replaced by other vasopressor drugs, such as vasopressin without effects on beta-receptors.
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Acta Anaesthesiol Scand · Apr 2010
Review Meta AnalysisPremedication with clonidine is superior to benzodiazepines. A meta analysis of published studies.
Premedication is considered important in pediatric anesthesia. Benzodiazepines are the most commonly used premedication agents. Clonidine, an alpha2 adrenoceptor agonist, is gaining popularity among anesthesiologists. The goal of the present study was to perform a meta-analysis of studies comparing premedication with clonidine to Benzodiazepines. ⋯ Premedication with clonidine is superior to midazolam in producing sedation, decreasing post-operative pain and emergence agitation. However, the superiority of clonidine for PONV prevention remains unclear while other factors such as nausea prevention might interfere with this result.