Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2020
Randomized Controlled TrialUltrasound-guided transmuscular quadratus lumborum catheters for elective caesarean section: A protocol for a single-center, double-blind randomised trial.
Management of moderate-to-severe post-operative pain after elective caesarean section (ECS) is internationally primarily based on either epidural catheters or opioids. However, both techniques are associated with some undesirable adverse events. Bilateral transmuscular quadratus lumborum (TQL) block has proven to reduce opioid consumption significantly in the first 24 post-operative hours following ECS and prolong time to first opioid (TFO) (Hansen CKD, Steingrimsdottir M, Laier GE, et al. Reg Anesth Pain Med. 2019; 10.1136/rapm-2019-100540). We present a randomised controlled trial aiming to investigate whether continuous analgesia via bilateral TQL catheters can prolong TFO after ECS. ⋯ Four patients were included from September 2018 to November 2018. Inclusion was resumed in June 2019 and will continue until 24 patients with useful data have been included in the trial. Expected inclusion period is 10-14 months.
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Acta Anaesthesiol Scand · Sep 2020
Randomized Controlled TrialThe effect of rocuronium on ventilatory leak and sealing pressure using a supraglottic airway device: a randomized clinical trial.
The transition of ventilatory leak and sealing pressure in supraglottic airway devices after administration of neuromuscular blocking agents is unclear. We hypothesized that ventilatory leak would decrease due to the increase in sealing pressure after administration of 0.15 and 0.30 mg/kg rocuronium iv. ⋯ Our results suggest that ventilatory leak with a supraglottic airway device decreases independently of neuromuscular blockade, although the neuromuscular blockade may potentially decrease sealing pressure. Registration of Clinical trials: UMIN Clinical Trials Registry (registration ID: UMIN000027061, URL: https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000031018).
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Acta Anaesthesiol Scand · Sep 2020
Preoperative transthoracic echocardiography in ambulatory surgery- a cross sectional study.
Cardiac disease and aberrations in central volume status are risk factors for perioperative complications, and should be identified prior to surgery. This study investigated the benefit of transthoracic echocardiography (TTE) for pre-operative identification of cardiac disease and hypovolemia in ambulatory surgery. ⋯ In this ambulatory surgical cohort, a high prevalence of pre-operative LV dysfunction and aberrations in volume status was observed. The results demonstrate that pre-operative TTE contributed valuable hemodynamic information. The standard pre-operative assessment for this cohort might need to be revised.
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Acta Anaesthesiol Scand · Sep 2020
Exposure to surgery is associated with better long-term outcomes in patients admitted to Swedish intensive care units.
Long-term outcomes of patients admitted to intensive care units (ICUs) after surgery are unknown. We investigated the long-term effects of surgical exposure prior to ICU admission. ⋯ Long-term ICU mortality was associated with known risk factors such as age and SAPS3. Transfer to other ICUs also appeared to be a risk factor and requires further investigation. Prior surgical exposure was associated with better outcomes, a noteworthy observation given limited ICU admissions after surgery in Sweden.
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Acta Anaesthesiol Scand · Sep 2020
Comparative StudyOnset time and duration of action of rocuronium 0.6 mg/kg in patients above 80 years of age: A comparison with young adults.
The number of elderly is increasing, and a large proportion of these people will require surgery and anaesthesia. However, little data exist regarding rocuronium in patients above 80 years of age. The aim of this study was to determine the onset time and duration of action for rocuronium 0.6 mg/kg in patients above 80 years compared with young adults. ⋯ Patients above 80 years had significantly prolonged onset time and duration of action after rocuronium 0.6 mg/kg compared with patients aged 18-40 years.