Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1983
Randomized Controlled Trial Clinical TrialPerivascular axillary block II: influence of injected volume of local anaesthetic on neural blockade.
Perivascular axillary blockade was performed on 150 patients with the aid of a catheter technique. Blockade failure due to injection outside the neurovascular sheath was found in 5.7% of the subject material. The patients were randomly allocated to three groups. ⋯ Sensory and motor blockade was tested 30 min after each injection. The following results were obtained: 1) Apart from the axillary, musculocutaneous and radial nerves, a high frequency of analgesia was found in all cutaneous areas (over 85%). 2) In the axillary area, improvements were found with increasing volume. 3) Analgesia in the musculocutaneous area occurred in 52% of the patients in group 1 (20 ml) and improved to 75% in group 2 (40 ml). However, no difference was found between group 2 and group 3 (80 ml). 4) Volume had no influence on analgesia in the radial area. 5) Motor blockade was intensified with decreasing volume, i.e. with an increase of concentration of local anaesthetic solution.
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Acta Anaesthesiol Scand · Apr 1983
Randomized Controlled Trial Clinical TrialLidocaine given intravenously as a suppressant of cough and laryngospasm in connection with extubation after tonsillectomy.
The preventive effect of lidocaine against coughing in the recovery period after general anaesthesia was observed. The study was carried out as a double-blind sequential trial. At the same time the incidence of laryngospasm was registered. ⋯ Nineteen patients for tonsillectomy, all of them over the age of 15, randomly received a 2% solution of lidocaine 2 mg/kg body weight or placebo (saline) 2 min prior to expected extubation. We found that lidocaine in this dose given prophylactically just before extubation was able to inhibit and prevent coughing in the recovery period after general anaesthesia. None of the patients included in this study got laryngospasm, and none of the patients developed serious side-effects.
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Acta Anaesthesiol Scand · Apr 1983
Effect of age on the establishment of muscle paralysis induced in anaesthetized adult subjects by ORG NC 45.
The establishment of muscle paralysis produced by a single dose of 70 micrograms . kg-1 of ORG NC 45 was studied in 30 healthy anaesthetized patients, aged 15-85 years, by recording adductor pollicis isometric mechanical activity-twitch height (TH). Significant correlations were observed between age and the latency of ORG NC 45 action, defined as the reduction of TH to 95% of its initial value (r:0.315, P less than 0.05) and between age and the onset time, defined as the time elapsing between ORG NC 45 administration and maximum TH depression observed (r:0.454, P less than 0.005). Correlation between age and maximum TH depression was not significant. These results show that if the maximum TH depression observed after a standard dose of ORG NC 45 is not altered by the age of the patient, the establishment of the paralysis is delayed by ageing.
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Acta Anaesthesiol Scand · Feb 1983
Comparative StudyCardiac arrhythmias in non-intubated children during adenoidectomy. A comparison between enflurane and halothane anaesthesia.
The incidence of cardiac arrhythmias, heart rate, blood pressure, capillary perfusion and end-tidal CO2 tension were studied in 167 healthy children 1-12 years of age undergoing adenoidectomy (n = 82) and myringotomy (n = 85) during enflurane and halothane anaesthesia. The incidence of cardiac arrhythmias was significantly lower during myringotomy than during adenoidectomy. In children undergoing adenoidectomy the incidence of arrhythmias was 38.9% during enflurane anaesthesia and 86.6% during halothane anaesthesia (P less than 0.001). ⋯ Heart rate was increased by about 40% at the onset of ventricular arrhythmias. The heart rate remained unchanged with enflurane anaesthesia during surgery, which may reflect a decreased sympathomimetic activity. It is suggested that the low incidence of ventricular arrhythmias during enflurane anaesthesia may be explained by the combination of a reduced sympathomimetic activity and a lowered susceptibility of the myocardium to the actions of endogenous catecholamines.
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Acta Anaesthesiol Scand · Feb 1983
Comparative Study Clinical Trial Controlled Clinical TrialTranscutaneous PO2 monitoring during treatment with continuous positive airway pressure in infants with idiopathic respiratory distress syndrome.
During a 20-month period, 20 infants with idiopathic respiratory distress syndrome (IRDS) were treated with continuous positive airway pressure (CPAP) when they required at least 40% inspired oxygen. The infants were allocated to monitoring with either repeated blood-gas determinations according to the usual practice or continuous transcutaneous PO2 measurements supplemented by blood-gas measurements only when judged necessary. ⋯ However, PtcO2 monitoring resulted in significantly less hypo- and hyperoxaemia and the number of blood-gas analyses performed during CPAP therapy amounted to only 0.6 per infant per day in the transcutaneously monitored group as against 5.3 in the other group. We propose that PtcO2 monitoring should now be the method of choice and that the use of umbilical artery catheterization should be restricted to selected groups of very low birth-weight infants and to infants in need of ventilator therapy.