Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 1992
The effect of acute hypothermia and serum potassium concentration on potassium cardiotoxicity in anesthetized rats.
We examined the effects of hypothermia on serum K+ concentration and the interaction of body temperature and K+ load on cardiac toxicity in anesthetized rats. Serum K+ concentration significantly decreased to 2.61 +/- 0.13, 2.59 +/- 0.19 and 2.39 +/- 0.14 mmol/l at 31.0 degrees C, 28.0 degrees C and 25.0 degrees C, respectively, from the control value of 2.80 +/- 0.15 mmol/l at 37.0 degrees C. ⋯ These data indicate that the level at which an elevation of serum K+ concentration causes cardiac toxicity diminishes with progressive hypothermia. We conclude that hypothermia induces hypokalemia, possibly through redistribution, and that the myocardium appears to be more sensitive to the toxic effects of K+ as hypothermia deepens.
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Acta Anaesthesiol Scand · Nov 1992
Randomized Controlled Trial Comparative Study Clinical TrialSublingual premedication with brotizolam.
This randomized, double-blind and double-dummy study was carried out in order to compare the perioperative sedation after premedication with either brotizolam 0.25-0.50 mg sublingually or diazepam 5-10 mg orally. Sixty-two patients aged 18-60 years scheduled for minor gynaecological surgery in general anaesthesia were included. Assessments were: 1. auditory continued response time (ACRT); 2. coma scale; 3. anxiety scale; and 4. final patient questionnaire. ⋯ The final questionnaire showed (P < 0.05) that the brotizolam group was more satisfied with the effect of the premedication. Seven hours after the premedication the ACRT scores in both groups were similar to those before premedication and all the patients could walk about freely. In conclusion, as a premedicant in outpatients sublingual brotizolam appears to be a good alternative to diazepam.
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Acta Anaesthesiol Scand · Nov 1992
Recollections of general anaesthesia: a survey of anaesthesiological practice.
In order to identify the factors to which patients attach importance when undergoing general anaesthesia, 678 patients were retrospectively asked about their recollections of previous anaesthetics during routine preoperative screening over a period of 14 months. The most frequently mentioned recollections concerned the post-anaesthetic period, followed by recollections of the induction of anaesthesia. From the post-anaesthetic period, nausea/vomiting and drowsiness were most often cited. ⋯ More than a quarter of the patients were not satisfied with the anaesthesia. No correlation was found between the assessment of the anaesthesia and complaints about nausea/vomiting and drowsiness. The possible role of psychological factors in the origin of complaints about anaesthesia is discussed.
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Acta Anaesthesiol Scand · Nov 1992
A device for measuring the lateral wall cuff pressure of endotracheal tubes.
A new method for measuring the lateral wall pressure on the trachea from cuffs of endotracheal tubes is presented. The method is based on measuring the force necessary to force a small, constant flow of air through a Teflon or silicone rubber envelope, placed between the cuff and the tracheal wall. ⋯ Dynamic recordings of the lateral wall pressure of high and low residual volume cuffs can be obtained for analysis of the interaction between the cuff and the tracheal compliance. No method for accurate, dynamic recording of the lateral wall cuff pressure has previously been published.
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Acta Anaesthesiol Scand · Nov 1992
Elimination of apparatus dead space--a simple method for improving CO2 removal without increasing airway pressure.
During mechanical ventilation the apparatus dead space can be eliminated by insufflating through one lumen of a tracheal double-lumen tube and allowing expiration through the other. In six intravenously anesthetized pigs, this technique resulted in an 18% (1 kPa) decrease in PaCO2 compared with insufflating through both lumens (32 ml rebreathing volume). ⋯ Flushing the trachea with fresh gas during the expiratory phase did not improve the efficiency of ventilation. It is concluded that elimination of apparatus dead space improves CO2 removal without increasing airway pressures and tidal volumes, and it is suggested that minimization of apparatus dead space should be tried before more advanced ventilatory modes are considered.