Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 2019
Randomized Controlled TrialAre single-injection erector spinae plane block and multiple-injection costotransverse block equivalent to thoracic paravertebral block?
Thoracic paravertebral block (TPVB) is considered the gold standard for hemithoracic regional anaesthesia. Erector spinae plane block (ESPB) is a new posterior thoracic wall block. Multiple-injection costotransverse block (MICB) mimics TPVB but with injection points within the thoracic intertransverse tissue complex and posterior to the superior costotransverse ligament. We aimed to compare the spread of injectate into the thoracic paravertebral space (TPVS) resulting from single-injection ESPB and MICB, respectively, with TPVB. ⋯ Consistent spread of dye into the TPVS colouring the ventral rami, the communicating rami, and the sympathetic trunk was observed with MICB; in this respect equivalent to TPVB. ESPB exhibited only partial success and was not equivalent to TPVB. No epidural spread was found with neither MICB nor ESPB.
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Acta Anaesthesiol Scand · Oct 2019
Performance of SAPS II according to ICU length of stay: A Danish nationwide cohort study.
Intensive care unit (ICU) severity scores use data available at admission or shortly thereafter. There are limited contemporary data on how the prognostic performance of these scores is affected by ICU length of stay (LOS). ⋯ We observed that discrimination and calibration of SAPS II decreased with increasing ICU LOS, and that this affected SMRs. These findings should be acknowledged when using SAPS II for clinical, research and administrative purposes.
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Acta Anaesthesiol Scand · Oct 2019
Comparative StudyRetrospective analysis of 1-year mortality after gastric cancer surgery: Total intravenous anesthesia versus volatile anesthesia.
It remains controversial whether propofol-based total intravenous anesthesia (TIVA) or inhalation anesthesia is associated with better outcomes after cancer surgery. We investigated whether there is a difference in the 1-year overall or cancer-related mortality between propofol-based TIVA and inhalation anesthesia in patients who underwent gastric cancer surgery. ⋯ We show that propofol-based TIVA was not significantly associated with a decrease in the 1-year overall or cancer-related mortality after gastric cancer surgery, as compared with inhalation anesthesia. Further studies are required to ascertain the optimal anesthetic choice for gastric cancer surgery.
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Acta Anaesthesiol Scand · Oct 2019
Delayed cerebral ischaemia in patients with aneurysmal subarachnoid haemorrhage: Functional outcome and long-term mortality.
Delayed cerebral ischaemia (DCI) is one of the most frequent complications of aneurysmal subarachnoid haemorrhage (aSAH). The purpose of the present retrospective cohort study of patients with aSAH was to identify the association between DCI, functional outcome and 4-year mortality. ⋯ DCI may be associated with both short- and long-term morbidity and mortality in patients with aSAH.
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Acta Anaesthesiol Scand · Oct 2019
Observational StudyInadequate emergence after non-cardiac surgery-A prospective observational study in 1000 patients.
The post-anaesthetic phase is most often uncomplicated, but patients may experience inadequate emergence (IE) characterized by unrest, restlessness, aggressiveness or in contrast sedation or lack of initiative. This may increase length of stay (LOS) and post-operative complications. The aim of this study was to investigate frequency, risk factors and consequences of IE. ⋯ One of 10 patients had IE as defined by the Nu-DESC score, which was significantly associated with increased LOS. Longer duration of anaesthesia, inhalational anaesthesia and ASA ≥3 were significantly associated to this.