Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2014
Anesthetic practice for Caesarean section and factors influencing anesthesiologists' choice of anesthesia: a population-based study.
We examined the change in anesthetic practice for Caesarean section (CS) during the past decade and determined factors influencing anethesiologists' decisions. ⋯ Spinal anesthesia was the most common mode of anesthesia for CS deliveries in Taiwan during the past decade. Early or threatened labor, antepartum hemorrhage, emergency CS, previous CS, and preeclampsia are significant determinants of general anesthesia in CS deliveries.
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Acta Anaesthesiol Scand · Aug 2014
Randomized Controlled Trial Comparative StudyIntubation conditions in young infants after propofol and remifentanil induction with and without low-dose rocuronium.
Bolus injections of intravenous propofol and remifentanil can be used in the tracheal intubation of infants and children, but relatively large doses are needed. We hypothesised that addition of a small bolus of rocuronium would ensure good intubation conditions when modest propofol and remifentanil doses were used. ⋯ Intubation conditions were poor in almost one third of the patients receiving propofol-remifentanil. Adding a low-dose rocuronium did not significantly improve intubation conditions.
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Acta Anaesthesiol Scand · Aug 2014
A series of severe necrotising soft-tissue infections in a regional centre in Sweden.
Necrotising soft-tissue infections (NSTIs) are rare conditions with high morbidity and mortality. Patients with NSTIs are often transferred to tertiary hospitals, but the question of whether the potential benefits of highly specialised care outweigh the risks associated with inter-hospital transfers has been raised. ⋯ Patients with NSTIs develop severe local and systemic symptoms and require extremely resource-demanding hospitalisation. Inter-hospital transfer was not associated with a delay in key interventions and could not be identified as a risk factor for adverse outcome.
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Acta Anaesthesiol Scand · Aug 2014
Case ReportsPriapism following continuous thoracic epidural anaesthesia: emergency or a benign condition?
Priapism is a rare complication of epidural anaesthesia, and the pathophysiology is poorly understood. In general, 95% of all priapism episodes are ischemic because of decreased penile blood flow, and therefore requires immediate treatment. ⋯ However, confirmation by serial cavernous blood gas analysis or colour duplex ultrasonography is mandatory. Until this hypothesis is confirmed, termination of epidural infusion is advised as a primary treatment.
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Acta Anaesthesiol Scand · Aug 2014
Case ReportsSubdural hygroma accompanied by parenchymal and subarachnoid haemorrhage after epidural analgesia in an obstetric patient.
Anaesthetists need to know the different causes of persistent headache or a change in level of consciousness following epidural analgesia for labour. Failure to recognise these neurological complications can lead to delayed diagnoses, with subsequent serious implications. ⋯ Neurological signs should alert the clinician to the possibility of subdural collection and other possible complications such as sinking of the brain in order not to delay the request for imaging tests for diagnoses and effective treatments.