Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Dec 1984
Comparative StudyThe measurement of tidal volumes in spontaneously breathing children during general anaesthesia using a Haloscale infant Wright respirometer.
The accuracy of tidal volume measurements made with a Wright Haloscale infant respirometer in children breathing spontaneously during general anaesthesia was assessed by a bench test. The tidal volumes and peak flow rates of 20 spontaneously breathing, anaesthetised children were measured with a pneumotachograph before and during surgery, and similar volumes, at the same flow rates, were delivered by a calibrated syringe simultaneously to the respirometer and a pneumotachograph. The results reveal that the mean (+/- s.d.) peak gas flow rates of children aged 6 years and less, 7.5 (+/- 1.6) and 9.3 (+/- 0.1) l/min before surgery and during surgery respectively, are significantly less than the peak flow rates, 11.3 (+/- 1.0) and 11.9 (+/- 1.5) before and during surgery, respectively, of children aged more than 6 years; and that the respirometer underestimates tidal volume by 10% when the peak flow rate is 11 l/min, and the percentage error in tidal volume estimation by the respirometer increases as the peak gas flow declines below 10 l/min.
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Acta Anaesthesiol Scand · Dec 1984
Comparative StudyRectal diazepam compared to intramuscular pethidine/promethazine/chlorpromazine with regard to gastric contents in paediatric anaesthesia.
Sixty children, aged 1-12 years, were investigated with regard to gastric pH and volume before general anaesthesia. Thirty children (group D) received diazepam 0.75 mg/kg b.w. rectally 1 h before anaesthesia. Thirty children (group L) received a "lytic cocktail" (pethidine 28 mg, promethazine 7 mg, chlorpromazine 7 mg per ml) 0.05 ml/kg b.w. intramuscularly 1 h before anaesthesia. ⋯ The number of children in group L with gastric juice volume exceeding 0.4 ml/kg and the number of children with pH less than 2.5 was significantly smaller compared to group D. The number of children with both gastric pH less than 2.5 and gastric juice volume greater than 0.4 ml/kg was significantly smaller in the group receiving "lytic cocktail" intramuscularly compared to the group receiving diazepam rectally. Bile-stained gastric contents was not related to the gastric pH.
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Heat loss during anesthesia and operation and subsequent hypothermia will increase the postoperative oxygen demand and may endanger patients with restricted cardiopulmonary reserves. Forty patients scheduled for intra-abdominal aortic surgery and 40 patients scheduled for peripheral vascular surgery on the lower limbs were investigated using a warming blanket, humidified heated inspired anesthetic gases at 37-40 degrees C, or both these methods together. A fourth group of patients received no active warming. ⋯ The combination of humidified and heated inspired gases and a warming blanket gave significantly better heat preservation after 40 min (P less than 0.05). Patients undergoing peripheral vascular surgery had similar but smaller drops in temperature with the different types of warming procedures employed. The differences in temperature between the intra-abdominal and extra-abdominal operations were statistically significant after 3 h (P less than 0.05).
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Acta Anaesthesiol Scand · Oct 1984
Lateral positioning with differential lung ventilation and unilateral PEEP following unilateral acid aspiration in the dog.
Body position can significantly alter the efficiency of gas exchange following unilateral lung injury. We systematically examined three positions during differential lung ventilation with unilateral positive end-expiratory pressure (PEEP) following unilateral hydrochloric acid aspiration in the dog. Twelve mongrel dogs were intubated with a double-lumen endobronchial tube and mechanically ventilated with a microcomputer-controlled pair of ventilators. ⋯ There was no significant difference between the three positions with regard to PaO2 (F (2, 10) = 1.60, P = 0.25) of venous admixture (F (2, 10) = 0.49, P = 0.63). Our data indicated that position did not alter oxygenation. This was probably due to the use of differential ventilation with unilateral PEEP which eliminated redistribution of ventilation between the two lungs and minimized position-dependent changes in pulmonary blood flow.
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Acta Anaesthesiol Scand · Oct 1984
Comparative StudyDiazepam does not prevent succinylcholine-induced fasciculations and myalgia. A comparative evaluation of the effect of diazepam and d-tubocurarine pretreatments.
To determine the effectiveness of diazepam pretreatment in preventing succinylcholine (SCh)-induced fasciculations and body pains, 587 patients were randomly allocated to six groups. Patients in Group I received no pretreatment and served as controls. Patients in Groups II and III were pretreated with 0.05 mg/kg of diazepam either 4-5 min (Group II) or 8-10 min (Group III) prior to SCh administration. ⋯ There was no statistically significant difference in the incidence of body pains by virtue of site of operation, age, sex, and inpatient/outpatient status. It is concluded that the problem of postoperative myalgia is significant and that dTc pretreatment is the effective method for prevention of fasciculations and postoperative myalgia. Diazepam pretreatment was ineffective for the prevention of fasciculations and myalgia.