Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 2014
Observational StudyTissue near infra red spectroscopy change is not correlated with patients' outcome in elective cardiac surgery.
Microcirculatory disturbances following cardiac surgery with cardiopulmonary bypass (CPB) are thought to be at the origin of organ dysfunction, although few studies have correlated microvascular alterations with outcome. We aimed to assess the microcirculation with near infrared spectroscopy (NIRS) and correlate NIRS parameters with intensive care length of stay and organ dysfunction. ⋯ This study confirms, through a non-invasive technology, a significant but transient alteration of the microcirculation during elective cardiac surgery. However, as these microvascular alterations were not correlated with patient's outcome, NIRS-derived parameters seem to be of limited interest in the cardiac surgery setting.
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Acta Anaesthesiol Scand · Aug 2014
Comparative Study Clinical TrialThe median effective dose of dexmedetomidine for laryngeal mask airway insertion with propofol 2.0 mg/kg.
Dexmedetomidine can be used as a co-induction agent to facilitate laryngeal mask airway (LMA) insertion with minimal effect on respiratory function. The purpose of the study was to determine the median effective dose (ED50) of dexmedetomidine to facilitate LMA insertion during anaesthesia induction with propofol 2.0 mg/kg without neuromuscular blockade. ⋯ The single dose of dexmedetomidine for successful LMA insertion to be feasible in 50% of patients was 0.55 μg/kg during anaesthesia induction with propofol 2 mg/kg.
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Acta Anaesthesiol Scand · Aug 2014
Clinical TrialReal-time ultrasound-guided spinal anesthesia using the SonixGPS ultrasound guidance system: a feasibility study.
Real-time ultrasound-guided neuraxial blockade remains a largely experimental technique. SonixGPS® is a new needle tracking system that displays needle tip position on the ultrasound screen. We investigated if this novel technology might aid performance of real-time ultrasound-guided spinal anesthesia. ⋯ The SonixGPS® system simplifies real-time ultrasound-guided spinal anesthesia to a large extent, especially the out-of-plane approach. Nevertheless, it remains a complex multi-step procedure that requires time, specialized equipment, and a working knowledge of spinal sonoanatomy.
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Acta Anaesthesiol Scand · Aug 2014
Major complications of epidural anesthesia: a prospective study of 5083 cases at a single hospital.
We undertook a prospective study of non-obstetric epidurals placed in surgical inpatients at a single teaching hospital to evaluate the incidence of and potential risk factors for major complications of continuous epidural anesthesia. ⋯ Serious complications were very rare; only one patient had permanent sequelae, and a single epidural hematoma was diagnosed. Post-operative neurologic deficits were more common, but most complications resolved spontaneously within 3 months and they rarely required intervention.
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Acta Anaesthesiol Scand · Aug 2014
Assessing Nurse Anaesthetists' Non-Technical Skills in the operating room.
Incident reporting and fieldwork in operating rooms have shown that some of the errors that arise in anaesthesia relate to inadequate use of non-technical skills. To provide a tool for training and feedback on nurse anaesthetists' non-technical skills, this study aimed to adapt the Anaesthetists' Non-Technical Skills (ANTS) as a behavioural marker system for the formative assessment of nurse anaesthetists' non-technical skills in the operating room. ⋯ A behavioural marker system, N-ANTS, for nurse anaesthetists was adapted from a behavioural marker system, ANTS, for anaesthesiologists.