Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 2019
Pre-medication before dental procedures: A randomized controlled study comparing intranasal dexmedetomidine with oral midazolam.
This study aimed to determine if intranasal dexmedetomidine is a superior pre-medication to oral midazolam in older, difficult children. ⋯ Intranasal dexmedetomidine provides higher success rate in sedation and parental separation compared to oral midazolam, in older, difficult children.
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Acta Anaesthesiol Scand · Oct 2019
The ratio of PACU length-of-stay to surgical duration: Practical observations.
Operating room (OR) and post-anesthesia care unit (PACU) activity are closely linked since the number, type, and sequence of surgeries influence subsequent PACU activity. We aimed to explore the relationship between duration-of-surgery (DOS) and PACU length-of-stay (LOS), the PACU-LOS:DOS ratio, since it is among the determinants of the number of PACU beds and nurse staffing required to insure efficient egress of patients from the OR. ⋯ The PACU-LOS/DOS ratio proved useful for demonstrating interactions between 2 central components of the surgical system. The many patients with PACU-LOS:DOS ratios >1.0 provides objective evidence for the number of PACU beds exceeding the number of ORs.
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Acta Anaesthesiol Scand · Oct 2019
Randomized Controlled TrialEffect of pre-operative fluid therapy on hemodynamic stability during anesthesia induction, a randomized study.
Preserving perfusion pressure during anesthesia induction is crucial. Standardized anesthesia methods, alert fluid therapy and vasoactive drugs may help maintain adequate hemodynamic conditions throughout the induction procedure. In this randomized study, we hypothesized that a pre-operative volume bolus based on lean body weight would decrease the incidence of significant blood pressure drops (BPD) after induction with target-controlled infusion (TCI) or rapid sequence induction (RSI). ⋯ Pre-operative fluid bolus decreased the incidence of significant blood pressure drops during TCI and RSI induction of general anesthesia.
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Acta Anaesthesiol Scand · Oct 2019
Observational StudySubanesthetic ketamine infusions for the management of pediatric pain in non-critical care settings: An observational analysis.
Guidelines issued by the American Society of Regional Anesthesia and Pain Medicine suggest that ketamine infusions for acute pain management are advantageous as a primary treatment or as an opioid adjunct. Despite significant data regarding its use in adult patients, there remains a paucity of information related to its quality and side effect profile in pediatrics and how it can be effectively used. We aimed to summarize our practice of utilizing ketamine for pediatric pain management in non-critical care settings. ⋯ Ketamine can effectively be used as part of a multimodal analgesic regimen in pediatric patients in non-critical care settings. Our five-year experience using low-dose ketamine infusions highlights an acceptable side effect profile, with no attributable escalations in care or serious adverse events.
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Acta Anaesthesiol Scand · Oct 2019
Checking mask ventilation before neuromuscular block: A nation-wide survey of anaesthetists' attitudes and thinking.
The value of checking mask ventilation before administering neuromuscular blocking drugs is still debated. ⋯ We found several interesting comments about airway management at both practical and theoretical levels. The survey highlights that routinely performing a MVT is a common practice in Sweden in spite of the lack of evidence for increased patient safety. Future airway guidelines may need to address this practice.