Acta anaesthesiologica Scandinavica
-
Spinal anaesthesia is a safe and reliable anaesthetic modality for surgical procedures on the lower part of the body. However, because of the description of transient neurologic symptoms (TNS), most practitioners have abandoned intrathecal lidocaine. Chloroprocaine (2-chloroprocaine, CP) has been one candidate to replace lidocaine for short procedures, despite the fact that neurologic sequelae have been described following the intrathecal injection of large doses of preservative-containing CP intended for epidural use. ⋯ There have been five possible cases of TNS following CP spinal anaesthesia in over 4000 patients, and a regressive incomplete cauda equina syndrome has been described. The short duration of spinal CP makes it a strong contender for outpatient anaesthesia. It appears to have a lower risk of TNS than lidocaine.
-
Acta Anaesthesiol Scand · May 2013
Impact of a physician-staffed helicopter on a regional trauma system: a prospective, controlled, observational study.
This study aims to compare the trauma system before and after implementing a physician-staffed helicopter emergency medical service (PS-HEMS). Our hypothesis was that PS-HEMS would reduce time from injury to definitive care for severely injured patients. ⋯ Implementation of a PS-HEMS was associated with significant reduction in time to the trauma centre for severely injured patients. We also observed significantly reduced proportions of secondary transfers and 30-day mortality.
-
Acta Anaesthesiol Scand · May 2013
Outcomes in smokers and alcohol users after fast-track hip and knee arthroplasty.
Smoking and alcohol use impair post-operative outcomes. However, no studies include fast-track surgery, which is a multimodal-enhanced recovery programme demonstrated to improve outcome. We hypothesised that outcome is similar in smokers and alcohol users as in non-users after fast-track hip and knee arthroplasty. ⋯ Influence of smoking or alcohol use may be less pronounced in fast-track hip and knee arthroplasty compared with data with conventional care programmes.