Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2012
Randomized Controlled TrialDrug-administration sequence of target-controlled propofol and remifentanil influences the onset of rocuronium. A double-blind, randomized trial.
Remifentanil is known to cause bradycardia and hypotension, as well as the decreases of cardiac output (CO). We hypothesized that hemodynamic suppression by remifentanil would affect the onset time of rocuronium. This study investigated whether the onset of rocuronium was influenced by the drug-administration sequence during induction of anesthesia with target-controlled infusion of propofol and remifentanil. ⋯ The onset time of rocuronium is prolonged significantly by early administration of remifentanil during target-controlled infusion of propofol and remifentanil, and it may be due to the decreased CO caused by remifentanil.
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Acta Anaesthesiol Scand · May 2012
Assessment of pain in sedated and mechanically ventilated patients: an observational study.
Critically ill patients often undergo unpleasant procedures. We quantified the effects of an unpleasant stimulus on physiological and behavioral parameters and evaluated how they are modified by sedation and analgesia. ⋯ Intratracheal suctioning evoked significant changes in some physiological and behavioral parameters. Some physiological changes were suppressed by analgesia, but at our ICU's standard doses, neither analgesia nor sedation attenuated changes in behavioral parameters at the intensity tested.
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Acta Anaesthesiol Scand · May 2012
Comparative StudyVerification of endotracheal intubation in obese patients - temporal comparison of ultrasound vs. auscultation and capnography.
Ultrasound (US) may have an emerging role as an adjunct in verification of endotracheal intubation. Obtaining optimal US images in obese patients is generally regarded more difficult than for other patients. This study compared the time consumption of bilateral lung US with auscultation and capnography for verifying endotracheal intubation in obese patients. ⋯ In obese patients, verification of endotracheal tube placement with US is as fast as auscultation alone and faster than the standard method of auscultation and capnography.
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Acta Anaesthesiol Scand · May 2012
Perioperative inflammatory response and protein S-100β concentrations - relationship with post-operative cognitive dysfunction in elderly patients.
One major concern in about one third of elder patients after total hip-replacement surgery is post-operative cognitive dysfunction (POCD). Previous studies have suggested that cognitive impairment is accompanied with changes in serum S-100β protein (S-100β) and inflammatory markers. Thus, the aim of the current study was to investigate the value of serum S-100β and interleukin(IL)-1β, IL-6, tumour necrosis factor-α (TNF-α), and C-reactive protein (CRP) in reflecting POCD after total hip-replacement surgery. ⋯ The serum levels of pro-inflammatory marker IL-6 and S-100β protein increased after total hip-replacement in elderly patients, and such increase may serve as predicting parameters for the occurrence of POCD.