Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 1982
Randomized Controlled Trial Clinical TrialModerate hypotensive anaesthesia for reduction of blood loss during total hip replacement.
Thirty-two consecutive patients scheduled for total hip replacement were randomly allocated to receive either neurolept anaesthesia or halothane anaesthesia. In the halothane group, systolic blood pressure was reduced to 10.69-13.33 kPa in normotensive patients, and to 13.33-16.0 kPa in hypertensive patients by adjusting the inspired halothane concentration and using supplementary fentanyl when necessary. ⋯ The average peroperative blood loss in the halothane group was 809 ml (range 250-1700 ml); this was significantly lower than in the neurolept anaesthesia group in which an average blood loss of 1909 ml (range 600-4900 ml) occurred. Moderate hypotensive halothane anaesthesia is recommended as an anaesthetic technique for total hip replacement.
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Acta Anaesthesiol Scand · Jun 1982
Randomized Controlled Trial Clinical TrialAttenuation of the circulatory response to laryngoscopy and intubation by fentanyl.
The effects of fentanyl on arterial pressure and heart rate increases during laryngoscopy and intubation were studied in 45 normotensive, surgical patients, who were randomly allocated to three groups receiving 2 or 6 micrograms/kg of fentanyl or saline in a double-blind fashion before anaesthetic induction with thiopental. Fentanyl supplementation with 2 micrograms/kg significantly attenuated the arterial pressure and heart rate increases during laryngoscopy and intubation, and fentanyl, 6 micrograms/kg, completely abolished these responses. Moreover, fentanyl given during the induction decreased the amount of fentanyl needed during the operation. Respiratory depression was not observed during recovery.
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The intellectual and technological roots of respirators and respiratory care may be traced back hundreds of years. The clinical evolution has taken the better part of a century, and it has been most closely linked to the development of open-chest surgery. Resuscitation and the treatment of poliomyelitis also have contributed ideas and technology to this evolution. ⋯ Open-chest surgery forced the change from single-agent deep anesthesia with spontaneous ventilation to a balanced technique, using multiple drugs or agents, with controlled ventilation. Open-chest surgery also necessitated that physicians specialize in anesthesiology. Scandinavian scientists and physicians have contributed greatly to the field of respirators and respiratory care, as has the specialty of anesthesiology.
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Acta Anaesthesiol Scand · Jun 1982
Comparative StudyAnesthetic techniques and surgical blood loss in total hip arthroplasty.
Blood loss during total hip arthroplasty and the relation of different anesthetic techniques to surgical bleeding was explored in a consecutive, prospective study involving 157 patients with no previous history of hip surgery. Intraoperative blood loss was significantly reduced in patients operated under sodium nitroprusside induced hypotensive anesthesia as compared to halothane, NLA or epidural block. It might be suspected that postoperative blood loss is increased when the lowered blood pressure is raised towards normotension, but this was not the case. ⋯ Blood loss was greater with NLA and halothane anesthesia than with epidural block. The authors consider controlled hypotension a useful adjuvant in anesthesia for total hip arthroplasty in selected patients. Epidural block, on the other hand, is a suitable anesthetic technique for most patients and has the additional advantage of reduced surgical bleeding as compared to general anesthesia.