Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 1985
Historical ArticleThe introduction of ether anaesthesia in the Nordic countries.
The way in which the news about ether anaesthesia went from U. S. A. to Europe is briefly described. ⋯ In Norway, ether was used on 4 March in Christiania (Oslo), and in Finland on 8 March in Helsingfors (Helsinki). Anaesthesia in Iceland cannot be traced any earlier than 1856. A table shows when the first anaesthetics were given in different places in Europe and the world.
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Acta Anaesthesiol Scand · Jan 1985
A method for epiduroscopy and spinaloscopy. Presentation of preliminary results.
A method for endoscopic observation of the epidural space, epiduroscopy, and the subarachnoid space, spinaloscopy, in the lumbar region is described using the Olympus Selfoscope SES 1711 S. The preliminary results of 30 consecutive attempts at epiduroscopy on randomly chosen autopsy cases, with 28 successes, are presented. Five spinaloscopies were performed on the same material. The results justify the conclusion that epiduroscopy and spinaloscopy are methods that can be used for study of individual variation of the contents of the lumbar epidural and subarachnoid spaces.
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Acta Anaesthesiol Scand · Jan 1985
Comparative StudyEffect of anaesthesia on respiratory function after major lower extremity surgery. A comparison between bupivacaine spinal analgesia with low-dose morphine and general anaesthesia.
Postoperative pulmonary function was studied in 16 patients undergoing total hip or knee arthroplasty. Their mean age was 65 years. Half of them received spinal analgesia (22.5 mg bupivacaine + 0.3 mg morphine) and the other half underwent general anaesthesia with halothane-nitrous oxide. ⋯ Simultaneously, PA-ao2 was increased, and Pao2 remained reduced despite increased alveolar ventilation (lowered PaCo2). In the general anaesthesia group FVC, FRC and CC were also reduced, but the gas distribution index remained at the awake level and blood gases were unaltered. It is suggested that the slight hypoventilation in the spinal analgesia group early after surgery may have contributed to impaired gas distribution and ventilation-perfusion matching later postoperatively.
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Acta Anaesthesiol Scand · Dec 1984
Randomized Controlled Trial Comparative Study Clinical TrialPerivascular axillary block V: blockade following 60 ml of mepivacaine 1% injected as a bolus or as 30 + 30 ml with a 20-min interval.
Perivascular axillary blockade was performed on 60 patients with the aid of a catheter technique. The patients were randomly allocated to two groups. All patients received the same dose of local anaesthetic: 60 ml of mepivacaine 1% with adrenaline, but one group received the dose as a bolus injection, whereas the other group received the dose as fractional injections of 30 + 30 ml with an interval of 20 min. ⋯ There was no difference in blood concentrations of mepivacaine between the two groups. None of the 60 patients showed any sign of systemic toxic reactions. Fractional injection of local anaesthetic in perivascular axillary blockade does not offer any advantage over bolus injection with regard to the resulting blockade.
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Acta Anaesthesiol Scand · Dec 1984
Distribution of expiratory gas and rebreathing in a T-piece modification combined with a PEEP valve.
T-piece modifications with PEEP valves are often used in weaning from mechanical ventilation or for intubated patients not requiring ventilatory support. Distribution of expiratory gas and the extent of rebreathing in a T-piece modified with an inspiratory reservoir (ICR) and with a PEEP valve were studied in a model with various fresh gas flows (FGF), tidal volumes and frequencies at three valve settings: 0 cmH2O (ZEEP) and PEEP of 5 and 10 cmH2O (0.490-0.981 kPa). Two types of distribution of expiratory gas were delineated: type one with expiratory gas in the inspiratory limb (IL) and a high ratio of the maximum CO2 content and corresponding end-expiratory CO2 concentration in the expiratory limb (EL) (FmaxCO2/FECO2) and a type 2 with no detectable alveolar gas in the IL and a low ratio of FmaxCO2/FECO2. ⋯ The ratio of FGF to minute ventilation just preventing rebreathing during spontaneous ventilation is approximately 1, in contrast to 3 in other modifications. These advantages minimize the risk of rebreathing, even when the minute ventilation rises to that of the fresh gas flow. The T-system with a compliant inspiratory reservoir and a PEEP valve can, in most clinical weaning situations, satisfy the inspiratory peak flow of different respiratory patterns with a standard FGF of 15 l X min-1.