Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2020
Observational StudyHypoxemia following hospital discharge after fast-track hip- and knee arthroplasty-a prospective observational study subanalysis.
Post-operative hypoxemia is prevalent in hospitalized patients and may adversely affect recovery. However, little data exist on the post-discharge phase or details on duration, severity and potential risk factors. Thus, we investigated the incidence and risk factors for severe desaturation during the first post-operative week after THA/TKA by continuous nocturnal oxygen saturation monitoring. ⋯ One third of the patients suffered from increased and prolonged episodes of severe nocturnal hypoxemia during the first week after THA/TKA discharge. Increased risk for severe hypoxemic episodes was related to pre-operative hypoxemia.
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Acta Anaesthesiol Scand · Nov 2020
Controlled Clinical TrialThe effect of preoperative anxiety on phenylephrine dose during cesarean delivery: an open controlled one-arm clinical trial.
We performed an open controlled one-arm clinical trial to assess whether preoperative anxiety influences phenylephrine dosage required to maintain normotension during cesarean section under spinal anesthesia. ⋯ In conclusion, we did not find a large independent effect of preoperative anxiety on phenylephrine dose required to maintain normotension in our cohort. We believe that spinal hypotension and phenylephrine dose requirement are multifactorial and anxiety is only one of the factors in this complex interaction.
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Acta Anaesthesiol Scand · Nov 2020
Randomized Controlled TrialLung volume changes in Apnoeic Oxygenation using Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) compared to mechanical ventilation in adults undergoing laryngeal surgery.
Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) using high-flow 100% oxygen during apnoea has gained increased use during difficult airway management and laryngeal surgery due to a slower carbon dioxide rise compared to traditional apnoeic oxygenation. We have previously demonstrated high arterial oxygen partial pressures and an increasing arterial-alveolar carbon dioxide difference during THRIVE. Primary aim of this study was to characterise lung volume changes measured with electrical impedance tomography during THRIVE compared to mechanical ventilation. ⋯ No difference in lung volume change over time, measured by electrical impedance tomography, was detected when using THRIVE compared to mechanical ventilation during laryngeal surgery.
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Acta Anaesthesiol Scand · Nov 2020
Randomized Controlled TrialProgrammed intermittent boluses vs continuous epidural infusion in labor using an adrenaline containing solution: a randomized trial.
Traditionally, epidural analgesia has been maintained using a continuous infusion (CEI) with the addition of patient-controlled boluses (PCEA). In recent years, programmed intermittent boluses (PIEB) has emerged as an alternative showing better efficacy in randomized studies. In this study, the aim was to test PIEB + PCEA vs CEI + PCEA using an epidural solution containing adrenaline. ⋯ For labor epidural analgesia infusions, to optimize the analgesic effect, additional programmed intermittent boluses can be used as an alternative to patient-controlled boluses only. In this clinical trial, no differences in drug consumption or analgesic effect was observed when comparing these two different epidural bolus controls programs.
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Acta Anaesthesiol Scand · Nov 2020
A marking of the cricothyroid membrane with extended neck returns to correct position after neck manipulation and repositioning.
Emergency front of neck airway access by anaesthetists carries a high failure rate and it is recommended to identify the cricothyroid membrane before induction of anaesthesia in patients with a predicted difficult airway. We have investigated whether a marking of the cricothyroid membrane done in the extended neck position remains correct after the patient's neck has been manipulated and subsequently repositioned. ⋯ The cricothyroid membrane can be identified and marked with the subject in the extended neck position. Then the patient's position can be changed as needed, for example to the 'sniffing' neck position for conventional intubation. If a front of neck airway access is required during subsequent airway management, the patient can be returned expediently to the extended-neck position, and the marking of the centre of the membrane will still be in the correct place.