Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2019
Randomized Controlled Trial Multicenter StudyCombination of Perineural and Wound Infusion After Above Knee Amputation - A randomized, controlled multicenter study.
Post-operative pain after an above-knee amputation is often severe, and in the elderly patients the adverse effects of post-operative opioids are evident. We hypothesized that continuous perineural local anesthetic infusion (CPI) combined to a wound infusion will reduce acute pain and opioid consumption compared to placebo after above knee amputation. ⋯ A combination of continuous perineural and wound local anesthetic infusion seems to diminish the intensity of stump pain after above knee amputation.
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Acta Anaesthesiol Scand · Nov 2019
Randomized Controlled Trial Comparative StudyDexmedetomidine versus propofol as sedation for implantation of neurostimulators: a single-center single-blinded randomized controlled trial.
During the lead implantation of most spinal cord neurostimulators, the patient has to be comfortable and without pain. However, the patient is expected to provide feedback during electrical mapping. Titrating sedatives and analgesics for this double goal can be challenging. In comparison with our standard sedative agent propofol, the pharmacological profile of dexmedetomidine is more conducive to produce arousable sedation. The latter, however, is associated with hemodynamic side effects. We investigated whether dexmedetomidine is preferable over propofol during neurostimulator implantation. ⋯ Dexmedetomidine sedation resulted in higher patient satisfaction and allowed for better arousable sedation than sedation with propofol. Although differences in hemodynamic parameters were found between the groups, these differences were not regarded as clinically relevant.
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Acta Anaesthesiol Scand · Nov 2019
Randomized Controlled TrialThe Use of Mannitol in Cardiopulmonary Bypass Prime Solution - Prospective Randomized Double-blind Clinical Trial.
The optimal prime solution for the cardiopulmonary bypass (CPB) circuit in adult cardiac surgery has not yet been defined. Mannitol is widely used in the priming solution for CPB despite the fact that there is no clear consensus on the role of mannitol in cardiac surgery. The aim of this study was to investigate the effect of mannitol in the CPB prime solution. ⋯ We observed no effects on osmolality of a prime solution containing mannitol compared to Ringer's acetate-based prime in patients with normal cardiac and renal function. The use of mannitol in the prime resulted in a short-term, significant decrease in sodium level.
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Acta Anaesthesiol Scand · Nov 2019
Impact of norepinephrine on right ventricular afterload and function in septic shock-a strain echocardiography study.
In this observational study, the effects of norepinephrine-induced changes in mean arterial pressure (MAP) on right ventricular (RV) systolic function, afterload and pulmonary haemodynamics were studied in septic shock patients. We hypothesised that RV systolic function improves at higher doses of norepinephrine/MAP levels. ⋯ Higher doses of norepinephrine to a target MAP of 90 mm Hg improved RV systolic function while RV afterload was not affected.
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Acta Anaesthesiol Scand · Nov 2019
The effect of sildenafil on pleural and peritoneal effusions after the TCPC operation.
We evaluated whether the administration of sildenafil in children undergoing the TCPC operation shortened the interval from the operation to the removal of the pleural and peritoneal drains. ⋯ Sildenafil administration, pre-operatively or within 24 hours after the TCPC operation, did not reduce the required time for pleural and peritoneal drains but was associated with a significantly higher positive fluid balance.