Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 2012
Randomized Controlled Trial Comparative StudyDiclofenac-tramadol vs. diclofenac-acetaminophen combinations for pain relief after caesarean section.
We compared the analgesic efficacy of diclofenac-acetaminophen combination with diclofenac-tramadol combination to optimize multimodal post-operative analgesia in women undergoing caesarean section. ⋯ Both diclofenac-tramadol and diclofenac-acetaminophen combinations can achieve satisfactory post-operative pain control in women undergoing caesarean section. The diclofenac-tramadol combination was overall more efficacious but associated with higher incidence of post-operative nausea.
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Acta Anaesthesiol Scand · Jul 2012
Post-operative pain treatment in Denmark from 2000 to 2009: a nationwide sequential survey on organizational aspects.
In Denmark, the first acute pain service (APS) was introduced in 1993. An important objective became to facilitate implementation of accelerated post-operative rehabilitation programmes (ACC) in selected procedures in abdominal, gynaecological and orthopaedic surgery. Therefore, it is of considerable interest to study the association between the developments of post-operative pain management and the ACC by sequential analyses from 2000 to 2009. ⋯ The study, spanning nearly a decade, illustrates that following an increase in number of APSs from 2000 to 2006, followed by a significant decline, a steadily increasing number of departments implemented ACC.
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Acta Anaesthesiol Scand · Jul 2012
Randomized Controlled Trial Comparative StudyLight levels of anaesthesia after relaxation for tracheal intubation - comparison of succinylcholine and cis-atracurium.
Use of a single bolus of a hypnotic together with non-depolarizing muscle relaxants for anaesthesia induction may cause inappropriate light levels of anaesthesia (ILLA). The purpose of this study was to compare the incidence of ILLA during anaesthesia induction using either cis-atracurium (CIS) or succinylcholine (SUC). ⋯ The onset time of a muscle relaxant has substantial impact on the incidence of ILLA during induction of anaesthesia. Entropy and SEF may indicate the presence of ILLA.
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Acta Anaesthesiol Scand · Jul 2012
Dynamic variables of fluid responsiveness during pneumoperitoneum and laparoscopic surgery.
Few data exist on dynamic variables predicting fluid responsiveness during laparoscopic surgery. The aim of this study was to explore the effects of laparoscopy on four dynamic variables: respiratory variations in pulse pressure (ΔPP), stroke volume variation by Vigileo/FloTrac (SVV (Vigileo) ), pleth variability index (PVI) and respiratory variations in pulse oximetry plethysmography waveform amplitude (ΔPOP), and their relation to fluid challenges during laparoscopic surgery. ⋯ ΔPP and SVV (Vigileo) did not change as pneumoperitoneum was established, whereas PVI increased and ΔPOP tended to increase. All four dynamic variables predicted fluid responsiveness relatively poor during ongoing laparoscopic surgery. ΔPP and SVV (Vigileo) tracked changes in stroke volume induced by fluid challenges during ongoing laparascopic surgery, whereas ΔPOP and PVI did not.
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Acta Anaesthesiol Scand · Jul 2012
Randomized Controlled Trial Comparative StudyIntubation of the morbidly obese patient: GlideScope(®) vs. Fastrach™.
Several potential problems can arise from airway management in morbidly obese patients, including difficult mask ventilation and difficult intubation. We hypothesised that endotracheal intubation of morbidly obese patients would be more rapid using the GlideScope(®) (GS) (Verathon Inc Corporate Headquarters, Bothell, WA, USA) than with the Fastrach™ (FT) (The Laryngeal Mask Company Ltd, Le Rocher, Victoria, Mahe, Seychelles). ⋯ No significant difference between the two methods was found. The GS and the FT may therefore be considered to be equally good when intubating morbidly obese patients.