Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2011
Sufentanil preserves hemodynamics and left ventricular function in patients with ischemic heart disease.
Sufentanil has been reported to provide stable hemodynamics similar to other opioids. However, it has not been reliably established whether this stability can be attributed only to Sufentanil and translates into fully preserved left ventricular (LV) function. The purpose of this study was to evaluate the effect of Sufentanil on hemodynamics and LV systolic and diastolic function using invasive monitoring and echocardiography in patients with ischemic heart disease. ⋯ Sufentanil preserves hemodynamic parameters as well as echocardiographic indices of LV systolic and diastolic function in patients with ischemic heart disease (IHD).
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Acta Anaesthesiol Scand · Sep 2011
ReviewNeuraxial techniques in patients with pre-existing back impairment or prior spine interventions: a topical review with special reference to obstetrics.
Many anaesthetists consider neurological disorders of all kinds as a contraindication for regional anaesthesia particularly for neuraxial techniques. This hesitation is partly rooted in fears of medicolegal problems but also in the heterogeneous literature. Therefore, the present topical review is an attempt to describe the feasibility and the risks of neuraxial techniques in patients with spinal injury, anatomical compromise, chronic back pain or previous spinal interventions, ranging from 'minor' types like epidural blood patches to major surgery such as Harrington fusions. ⋯ When necessary, patients should have additional technical and clinical examinations as close as possible to surgery to establish the actual pre-operative status. Most patients may benefit more from spinal techniques rather than from less reliable epidural ones. High concentrations and volumes of local anaesthetics should be avoided at all times, especially in patients with nerve compression, large disc herniation or spinal stenosis.
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Acta Anaesthesiol Scand · Sep 2011
Randomized Controlled TrialSevere traumatic brain injury: consequences of early adverse events.
Several factors associated with an unfavourable outcome after severe traumatic brain injury (TBI) have been described: prolonged pre-hospital time, secondary referral to a level 1 trauma centre, the occurrence of secondary insults such as hypoxia, hypotension or low end-tidal carbon dioxide (ETCO(2)). To determine whether adverse events were linked to outcome, patients with severe TBI were studied before arrival at a level 1 trauma centre. ⋯ Early adverse events before arrival at a level 1 trauma centre were without significance for outcome after severe TBI in the trauma system studied.
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Acta Anaesthesiol Scand · Sep 2011
Randomized Controlled TrialEffect of L-carnitine on oxidative stress and platelet activation after major surgery.
The surgical/anesthesia trauma is associated with an increased production of reactive oxygen species (ROS). This enhanced oxidative stress leads to cell damage resulting in various complications such as sepsis, myocardial injury and increased mortality. The aim of this study was to investigate the role of antioxidant treatment with l-carnitine in oxidative stress and platelet activation in patients undergoing major abdominal surgery. ⋯ Our findings suggest that l-carnitine could be helpful in modulating oxidative stress and platelet activation during major abdominal surgery-dependent oxidative damage.