Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2014
Randomized Controlled TrialThe association of perioperative dexamethasone, smoking and alcohol abuse with wound complications after laparotomy.
A number of perioperative risk factors may suppress the immune system and contribute to the development of post-operative complications. The association between surgical site infection (SSI) and other wound-related complications resulting from immunosuppression through either perioperative administration of dexamethasone, pre-operative smoking or alcohol abuse is, however, uncertain. ⋯ Perioperative administration of dexamethasone was not significantly associated with SSI or other wound-related complications. Conversely, smoking and alcohol abuse were both significant predictors of the primary outcome consisting of wound-related complications and mortality.
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Acta Anaesthesiol Scand · Mar 2014
Case ReportsDelayed quadriceps weakness after continuous adductor canal block for total knee arthroplasty: a case report.
Adductor canal catheters have been shown to improve analgesia while maintaining quadriceps strength after total knee arthroplasty. We describe a patient who underwent total knee arthroplasty that likely had delayed quadriceps weakness as a result of a standard continuous 0.2% ropivacaine infusion at 8 ml/h within the adductor canal. ⋯ Contrast subsequently injected through the adductor canal catheter under fluoroscopy revealed proximal spread approaching the common femoral nerve with as little as 2 ml of volume. This rare case of profound quadriceps weakness after a continuous adductor canal block reveals that local anaesthetic at the adductor canal can spread in a retrograde fashion towards the common femoral nerve, potentially resulting in quadriceps weakness.
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Acta Anaesthesiol Scand · Mar 2014
Comparative StudyComparison of in-hospital and out-of-hospital cardiac arrest outcomes in a Scandinavian community.
Reported incidence and survival from in-hospital and out-of-hospital cardiac arrest show great variability, making it difficult to compare the groups. In order to eliminate effects of time and culture, we investigated out-of-hospital cardiac arrest compared with in-hospital cardiac arrest in our community over a 1-year period. ⋯ Survival from in-hospital and out-of-hospital cardiac arrest in this cohort is similar.
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Acta Anaesthesiol Scand · Mar 2014
Pre-treatment of bupivacaine-induced cardiovascular depression using different lipid formulations of propofol.
Pre-treatment with lipid emulsions has been shown to increase lethal doses of bupivacaine, and the lipid content of propofol may alleviate bupivacaine-induced cardiotoxicity. The aim of this study is to investigate the effects of propofol in intralipid or medialipid emulsions on bupivacaine-induced cardiotoxicity. ⋯ We conclude that pre-treatment with propofol in intralipid, compared with propofol in medialipid or saline, delayed the onset of bupivacaine-induced cardiotoxic effects as well as reduced plasma bupivacaine levels. Further studies are needed to explore tissue bupivacaine levels of propofol in medialipid and adapt these results to clinical practice.
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Acta Anaesthesiol Scand · Mar 2014
Analysis of intraosseous samples in endotoxemic shock--an experimental study in the anaesthetised pig.
Intraosseous (IO) access is used in emergency situations to allow rapid initiation of treatment. IO access is also sometimes used for blood sampling, although data on accuracy of such sampling in critical illness are limited. There is also a potential risk that bone marrow fragments in IO samples may damage laboratory equipment. It is ethically questionable to perform a simultaneous comparison between IO and arterial/venous sampling in critically ill humans. We have, thus, studied the analytical performance of IO sampling in a porcine septic shock model using a cartridge-based analyser. ⋯ IO sample values should be treated with caution in this setting but may add useful information to the clinical picture. The tibia or humerus may be used for sampling. IO infusion decreases agreement, thus sampling during infusion should be avoided.