Acta anaesthesiologica Scandinavica
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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
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.
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Acta Anaesthesiol Scand · Jul 2011
Randomized Controlled TrialHydroxyethyl starches and dextran during hip replacement surgery: effects on blood volume and coagulation.
Colloid fluids influence the coagulation system by diluting the plasma and, potentially, by exerting other effects that are unique for each fluid product. We hypothesised that changes in the coagulation measured at the end of surgery would be mainly governed by differences in half-life between the colloid fluids. ⋯ All tested colloid fluids induced a mild hypercoagulable state with faster clotting, but with weaker clot strength. The additive influence of surgery was relatively small, and postoperative changes in coagulation were mainly due to differences in the half-life of each colloid.