Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 2011
Data management in automated external defibrillators: a call for a standardised solution.
The ECG data stored in automated external defibrillators (AEDs) may be valuable for establishing a final diagnosis and deciding further diagnostics and treatment. Different data management systems are used and this may create significant problems for data storage and access for physicians treating victims in whom an AED has been used. ⋯ The development of data management solutions is not a high priority. We encourage the manufacturers to collaborate with researchers to develop a simple data transfer solution in order to improve patient care and facilitate research.
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Acta Anaesthesiol Scand · Jul 2011
Randomized Controlled Trial Multicenter StudyTrain-of-four ratio recovery often precedes twitch recovery when neuromuscular block is reversed by sugammadex.
Sugammadex reverses rocuronium-induced neuromuscular block (NMB). In all published studies investigating sugammadex, the primary outcome parameter was a train-of-four (TOF) ratio of 0.9. The recovery time of T1 was not described. This retrospective investigation describes the recovery of T1 vs. TOF ratio after the reversal of NMB with sugammadex. ⋯ After the reversal of NMB by sugammadex, full recovery of the TOF ratio is possible when T1 is still depressed. The TOF ratio as the only measurement for the adequate reversal of NMB by sugammadex may not always be reliable. Further investigations for clinical implications are needed.
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Acta Anaesthesiol Scand · Jul 2011
Randomized Controlled Trial Comparative StudyComparison of intrathecal bupivacaine and ropivacaine with different doses of sufentanil.
Spinal bupivacaine produces a complete anaesthetic block of a longer duration than ropivacaine, which leads to a potentially increased risk of failure. A combination of sufentanil to ropivacaine may improve the block's reliability. ⋯ Plain bupivacaine 10 mg has a longer recovery profile than the same dose of ropivacaine with or without sufentanil.
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Acta Anaesthesiol Scand · Jul 2011
Accuracy of the pleth variability index to predict fluid responsiveness depends on the perfusion index.
Respiratory variations in plethysmographic waveform amplitudes derived from pulse oximetry are believed to predict fluid responsiveness. The non-invasive pleth variability index (PVI) is a variable based on the calculation of changes in the perfusion index (PI). The aim of the following study was to examine whether the predictive power of PVI depends on different values of PI. ⋯ The PVI was not able to predict fluid responsiveness with sufficient accuracy. In patients with higher perfusion states, the PVI improved its ability to predict haemodynamic changes, strongly suggesting a relevant influence of the PI on the PVI.
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Acta Anaesthesiol Scand · Jul 2011
Randomized Controlled TrialSpread of local anesthetic during an ultrasound-guided interscalene block: does the injection site influence diffusion?
During interscalene block (ISB) placement, ultrasound guidance (USG) enables the practitioner to measure the spread of local anesthetic around the nerve trunks or roots, and to adjust the needle position in order to optimize diffusion. Moreover, USG helps determine the best injection level, i.e. the point from which diffusion gives the most complete brachial plexus block. The aim of this study was to compare C5 and C6 level injections and to determine which level allows the best diffusion. ⋯ During USG ISB placement, injection below the C6 level provided the same efficiency in analgesia after shoulder surgery as an injection cranial to the C5 nerve root but a greater success rate of anesthesia in all distal nerve areas. This technique could be very interesting for trauma cases as an alternative to a supraclavicular block and offers a high success rate and is simple to perform, potentially promoting wide use and quicker learning for beginners.