Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2013
Randomized Controlled TrialDosage finding for low-dose spinal anaesthesia using hyperbaric prilocaine in patients undergoing perianal outpatient surgery.
Hyperbaric prilocaine 20 mg/ml may be preferable for perianal outpatient surgery. The aim of this prospective, single-centre, randomised, single-blinded, controlled clinical trial was to determine the optimal dosage of hyperbaric prilocaine 20 mg/ml for a spinal anaesthesia (SPA) in patients undergoing perianal outpatient surgery. ⋯ Hyperbaric prilocaine 20 mg/ml can be applied in dosages of 10, 20 and 30 mg for SPA in perianal surgery. Because of sufficient analgesia, missing motor block and shorter recovery times, 10 mg of hyperbaric prilocaine 20 mg/ml can be recommended for perianal outpatient surgery.
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Acta Anaesthesiol Scand · Feb 2013
Randomized Controlled TrialOptimising stroke volume and oxygen delivery in abdominal aortic surgery: a randomised controlled trial.
Post-operative complications after open elective abdominal aortic surgery are common, and individualised goal-directed therapy may improve outcome in high-risk surgery. We hypothesised that individualised goal-directed therapy, targeting stroke volume and oxygen delivery, can reduce complications and minimise length of stay in intensive care unit and hospital following open elective abdominal aortic surgery. ⋯ Perioperative individualised goal-directed therapy targeting stroke volume and oxygen delivery did not affect post-operative complications, intensive care unit or hospital length of stay in open elective abdominal aortic surgery.
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Regional anesthesia is the preferred technique for Cesarean delivery. Strict aseptic precautions should be taken; otherwise, infectious complications including abscess formation, meningitis and necrotizing fasciitis may result. We report a case of a 26-year-old post-partum female who presented with necrosis of the skin of back following spinal anesthesia, which was administered for Cesarean delivery 5 days prior at a private nursing home. ⋯ We considered each possibility, and the most likely cause in our case appears to be infection from an already-used vial of a local anesthetic agent. Local anesthetics have bacteriostatic properties, but infection may still be transmitted through contaminated solutions. The present case highlights the importance of maintaining strict aseptic precautions, avoiding reusing multidose vials and early recognition of this complication as timely intervention can be lifesaving.
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Acta Anaesthesiol Scand · Feb 2013
The frequency and nature of drug administration error during anaesthesia in a Chinese hospital.
Throughout the world, drug administration error remains a known and significant threat to patients undergoing anaesthesia. Estimates of the extent of the problem vary, but few are based on large prospectively collected datasets. Furthermore, little is known about whether differences in work culture are important in error rates. ⋯ Our results are comparable with other international prospective estimates indicating that drug administration error is of concern in China as elsewhere. These results will form a baseline from which to detect the effects of countermeasures.
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Acta Anaesthesiol Scand · Feb 2013
Clinical impact of the publication of S3 guidelines for intensive care in cardiac surgery patients in Germany: results from a postal survey.
The development and implementation of practice guidelines might be an important tool to evaluate the different practices and to consider different local strategies. ⋯ Despite ongoing variability in the use of monitoring devices, volume replacement and vasopressor/inotrope use in cardiac surgery patients, there have been some changes in the therapy of these patients after publication of the guidelines. Because the guideline has been considered as clinically relevant, further interdisciplinary development and implementation support should be considered.