Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2012
Smooth emergence in men undergoing nasal surgery: the effect site concentration of remifentanil for preventing cough after sevoflurane-balanced anaesthesia.
Suppression of cough during emergence after nasal surgery is practical to avoid bleeding from the surgical site. Previously recommended effect-site concentration of remifentanil for preventing cough during emergence is restricted to female patients undergoing thyroid surgery, so we evaluated effective effect-site concentration of remifentanil for preventing cough during emergence for men undergoing nasal surgery. ⋯ The EC(95) of remifentanil for preventing cough in men after nasal surgery is 2.94 ng/ml. Remifentanil target-controlled infusion with established effect-site concentration could suppress cough in men during emergence from sevoflurane anaesthesia after nasal surgery, though reversible respiratory depression might arise at high effect-site concentration of remifentanil.
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Acta Anaesthesiol Scand · Apr 2012
Randomized Controlled TrialIntravenous lidocaine has no impact on rocuronium-induced neuromuscular block. Randomised study.
Intravenous lidocaine is increasingly used in surgical patients. As it has neuromuscular blocking effects, we tested the impact of an intravenous lidocaine infusion on the time course of a rocuronium-induced neuromuscular block. ⋯ A continuous intravenous infusion of lidocaine has no impact on the time course of the neuromuscular blockade induced by a standard intubation dose of rocuronium.
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Acta Anaesthesiol Scand · Apr 2012
Comparative StudyLack of agreement and trending ability of the endotracheal cardiac output monitor compared with thermodilution.
Minimally invasive monitoring systems of central haemodynamics are gaining increasing popularity. The present study investigated the precision of the endotracheal cardiac output monitor (ECOM) system and its agreement with pulmonary artery catheter thermodilution (PAC TD) for measuring cardiac output (CO) during steady state and with induced haemodynamic changes in patients scheduled for elective cardiac surgery. ⋯ In a direct comparison with PAC TD, the ECOM system did not show an acceptable agreement, with wide limits of agreement, a much larger percentage error than should be expected from the precision of the two methods and a very poor trending ability. Thus, the ECOM does not replace measurements done by thermodilution using a pulmonary artery catheter in cardiac surgery patients.
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Acta Anaesthesiol Scand · Apr 2012
Randomized Controlled TrialDexamethasone does not reduce pain or analgesic consumption after thyroid surgery; a prospective, randomized trial.
Post-operative analgesic effect of a perioperative fixed dose glucocorticoid has been demonstrated in studies on different surgical procedures. The aim of this study was to look for analgesic and opioid sparing effect after thyroid surgery with a weight-adjusted medium dose of dexamethasone compared with placebo or a higher dose. Further, to register other effects and side effects of dexamethasone in the 0–30 days postoperative period. ⋯ Dexamethasone had no analgesic or opioid sparing effect in our set-up after thyroid surgery. Dexamethasone reduced the incidence of PONV and led to a modest increase in blood sugar. A medium dose seems as effective as a higher dose.
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Acta Anaesthesiol Scand · Apr 2012
Xenon is not superior to isoflurane on cardiovascular function during experimental acute pulmonary hypertension.
Acute right ventricular afterload increase is a known perioperative challenge for the anaesthetic regime especially for patients with a compromised right ventricle. The accused negative inotropic action of volatile anaesthetics, with the exception of xenon, might be crucial for the adaptation of the right ventricle. ⋯ These results do not support the idea that xenon is more beneficial than isoflurane in right ventricular failure during pulmonary hypertension. Isoflurane did not compromise systolic ventricular function during acute PHT it only led to vasodilation in contrast to xenon.