Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2013
Antagonistic effect of flumazenil after midazolam sedation on arterial-cardiac baroreflex.
Flumazenil is generally administered to antagonise the sedative effect of midazolam. However, although flumazenil completely antagonises the sedative effect of midazolam, a few effects remain unantagonised. Hence, it is unclear whether flumazenil restores the attenuation of the arterial-cardiac baroreflex (i.e. arterial-heart rate reflex) induced by midazolam. We investigated the antagonistic effect of flumazenil administered after midazolam on cardiac baroreflex, to reveal whether complete recovery from midazolam-induced sedation by flumazenil administration is accompanied by restoration of midazolam's attenuating effects on the cardiac baroreflex. ⋯ The present results suggest that complete recovery from midazolam sedation by flumazenil is accompanied by restoration of the attenuated cardiac baroreflex function induced by midazolam.
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Acta Anaesthesiol Scand · Apr 2013
ReviewAn ethical analysis of proxy and waiver of consent in critical care research.
It is a central principle in medical ethics that vulnerable patients are entitled to a degree of protection that reflects their vulnerability. In critical care research, this protection is often established by means of so-called proxy consent. ⋯ If this is not fulfilled because the research is to be conducted under circumstances where the proxy is unavailable, adequate protection of the patient must be ensured by other means. Thus, the research must be designed specifically to benefit critically ill patients, and the incremental non-therapeutic risk must only comprise a minimal risk.
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Acta Anaesthesiol Scand · Apr 2013
Randomized Controlled TrialTransversus abdominis plane block or subcutaneous wound infiltration after open radical prostatectomy: a randomized study.
Open radical retropubic prostatectomy (ORRP) is associated with moderate pain. We hypothesized that a transversus abdominis plane (TAP) block would reduce post-operative pain, morphine consumption and opioid-related side effects compared with wound infiltration and placebo in this population. ⋯ Neither TAP block nor wound infiltration with ropivacaine improved a basic multimodal analgesic regimen with paracetamol, ibuprofen and gabapentin after ORRP.
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Acta Anaesthesiol Scand · Apr 2013
CNAP(®) does not reliably detect minimal or maximal arterial blood pressures during induction of anaesthesia and tracheal intubation.
CNAP(®) provides continuous non-invasive arterial pressure (AP) monitoring. We assessed its ability to detect minimal and maximal APs during induction of general anaesthesia and tracheal intubation. ⋯ The CNAP monitor could detect acute change in AP within a reasonable time lag. Precision of its measurements is not satisfactory, and therefore, it could only serve as a clue to the occurrence of changes in AP.