Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 2013
Current use of nitrous oxide in public hospitals in Scandinavian countries.
The use of nitrous oxide in modern anaesthesia has been questioned. We surveyed changes in use of nitrous oxide in Scandinavia and its justifications during the last two decades. ⋯ The use of nitrous oxide has decreased in the Scandinavian countries, apparently because many now prefer other agents. Difference in practices between the five countries were unexpected and apparently not justified on anticipated evidence only.
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Acta Anaesthesiol Scand · Oct 2013
Ultrasound measurement of subglottic diameter and an empirical formula for proper endotracheal tube fitting in children.
The appropriate endotracheal tube (ETT) size is commonly determined using age-based formula; ETT size determination based on ultrasound (US) measurement of subglottic diameter (SD), the narrowest portion of the paediatric upper airway, may provide a better method for accurate fit. We aimed to validate ETT size determination using US measures of SD before intubation to establish an empirical formula for ETT fitting based on SD and biographic parameters. ⋯ US-measured OD-ETT at SD was in good agreement with the actual OD-ETT, suggesting that US-measured SD helps in choosing the appropriate ETT diameter for children. In children older than 12 months, the equation 'OD (mm) = 0.01 × age (months) + 0.02 × height (cm) + 3.3' may help select the appropriate ETT.
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Acta Anaesthesiol Scand · Oct 2013
Skin temperature measured by infrared thermography after ultrasound-guided blockade of the sciatic nerve.
In the present study, we assessed the relationship between subgluteal sciatic nerve blocking and skin temperature by infrared thermography in the lower extremity. We hypothesized that blocking the sciatic nerve will lead to an increase in temperature, and that this will correlate with existing sensory block tests. ⋯ After sciatic nerve block, temperatures of the foot increased significantly. There was a good correlation between pinprick testing and infrared temperature measurement. This makes infrared skin temperature measuring a good test in determining block success when sensory testing is impossible.
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Acta Anaesthesiol Scand · Oct 2013
Comparative StudySevoflurane is less sensitive than halothane for in vitro detection of malignant hyperthermia susceptibility.
Sevoflurane is a known triggering agent of malignant hyperthermia (MH). The present study analyzed different effects of sevoflurane on skeletal muscle of MH susceptible and nonsusceptible individuals in vitro and compared the results to the standardized test protocol with halothane and caffeine. A potential influence of a present ryanodine receptor type 1 (RyR1) mutation was investigated. ⋯ Sevoflurane-induced contractures do not reliably detect MH susceptibility on an individual level. Therefore, sevoflurane is no suitable alternative for diagnostic use. Mutation-specific effects regarding contracture sizes after incubation with sevoflurane, halothane, or caffeine were not found.
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Acta Anaesthesiol Scand · Oct 2013
Diastolic dysfunction of the left ventricle is associated with pulmonary edema after renal transplantation.
Post-operative pulmonary complications are associated with high mortality and graft loss in renal transplantation recipients. Left ventricular diastolic dysfunction is not uncommon in patients with chronic renal failure, including those with preserved left ventricular systolic function. The purpose of this study was to determine the relationship between left ventricular diastolic dysfunction and incidence of post-operative pulmonary edema in renal transplantation recipients with preserved left ventricular systolic function. ⋯ Pre-operative left ventricular diastolic dysfunction correlated with the development of post-operative pulmonary edema in renal transplantation recipients. Meticulous intraoperative volume therapy is important to avoid post-operative pulmonary edema in such patients.