Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 1977
Arrhythmias during halothane anaesthesia II: the influence of atropine.
The effect of i.v. atropine premedication on cardiac rhythm was studied in healthy adult patients during thiopental-N2O/O2-halothane anesthesia without intubation. A higher incidnece of arrhythmias was seen in younger patients in close relation to administration of atropine, but the overall incidence during anesthesia was identical in atropine groups and the control groups. ⋯ No consistent changes in blood pressure were observed as the result of arrhythmias or changes in heart rate. It is concluded that atropine should be reserved for situations where severe bradycardia and hypotension occur, or can be expected to occur, and not given automatically, since cardioacceleration which is inherent in its action may be injurious to patients with limited cardiac reserve.
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Acta Anaesthesiol Scand · Jan 1977
Catheter technique in axillary plexus block. Presentation of a new method.
A flexible, disposable intravenous catheter can be introduced into the neuro-vascular sheath in the axilla and used for injection of local anesthetic solution to block the axillary brachial plexus. The technique is described and the results of the first 137 consecutive catheter blocks are reported and compared to a similarly evaluated series of conventional axillary blocks. The catheter method constitutes an interesting alternative to needle techniques and offers the possibility of a continuous axillary block.
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Acta Anaesthesiol Scand · Jan 1977
Peripheral nerve injury due to injection needles used for regional anesthesia. An experimental study of the acute effects of needle point trauma.
Nerve injury can arise as a complication peripheral nerve block anesthesia. Of the various factors involved, the trauma caused by the injection needle may be of significance. ⋯ Fascicular injury was indicated by a fluorescence microscopy technique, tracing locally applied Evans Blue Albumin, The results show that a 45 degrees-beveled needle less frequently produces fascicular damage and should therefore be recommended for use in clinical anesthesia. It is also concluded that paresthesiae, when necessary, should be elicited gently, and that intraneural injections should be avoided.
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Segmental epidural analgesia (T10-T12) was performed in 418 parturients, using a 4-6 ml dose of 0.5% bupivacaine, with or without adrenaline. Seventy per cent of parturients were primiparas and 30% had histories, or signs, of possible uteroplacental insufficiency. Our aim was to relieve pain during the long passive opening phase, so that mothers would be rested and active at the beginning of the second phase, but also to avoid abolishing the bearing-down reflex, the absence of which causes an increased frequency of instrumental delivery. ⋯ Slight, but rapidly correctable, hypotension occurred in 16.5%, and in two cases the hypotension led to more serious complications. This stresses the importance of the availability and competence of both the anaesthetic and obstetric teams. There were no maternal or neonatal mortalities, and the Apgar scores compared well with the figures for the normal material in our obstetric unit.