Acta anaesthesiologica Scandinavica
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Two young healthy non-asthmatic non-smoking patients developed partial laryngospasm directly post-anaesthesia extubation after routine varicocelectomy and perianal abscess drainage operations under general anaesthesia. Nitroglycerin was administered intravenously in a dose of 4 microg/kg for both cases. The laryngospasm was completely relieved within a minute of nitroglycerin administration in both cases and the relief was maintained thereafter. The two cases suggest that nitroglycerin can be effective in the treatment of post-extubation partial laryngospasm in ASA (class I) patients.
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Acta Anaesthesiol Scand · Nov 1999
Changes in stroke volume cause change in cardiac output in neonates and infants when mean airway pressure is altered.
Based on early studies in the lamb, and in spite of more recent studies in humans, it has been the received opinion that neonates and infants can not change their stroke volume significantly, but are mainly dependent on changes in heart rate, to change cardiac output. To further evaluate the relationship between cardiac output and stroke volume during mechanical ventilation of neonates and infants, we have studied the effects on cardiac output and stroke volume by two different ways of changing mean airway pressure. ⋯ We conclude that neonates and infants are able to regulate cardiac output by changing the stroke volume to a greater extent than presumed, at least when cardiac output is influenced by changes in the mean airway pressure.
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Acta Anaesthesiol Scand · Nov 1999
Effects of intrathecal morphine, clonidine and baclofen on allodynia after partial sciatic nerve injury in the rat.
Increased response to mechanical or cold stimulation of hind paws was observed in rats with partial sciatic nerve injury as a result of photochemically induced ischemia. The present study examined the effects of intrathecal morphine, clonidine and baclofen on the allodynia-like responses. ⋯ The present data suggest that intrathecal morphine, and to some extent clonidine, but not baclofen, alleviated the abnormal pain-related behaviors in this new rat model of partial peripheral nerve injury. Differences in the pharmacological profile between the present model and other models of peripheral nerve injury are discussed.
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Acta Anaesthesiol Scand · Oct 1999
ReviewOpioid use in cancer pain. Is a more liberal approach enhancing toxicity?
The majority of cancer patients develop pain before death. This pain has been shown to be underdiagnosed and undertreated. Opioid use has increased in the past 20 years in both developing and developed countries. ⋯ The syndrome of opioid-induced neurotoxicity (OIN) encompasses delirium, hallucinosis, myoclonus/seizures and hyperalgesia. Increased vigilance can lead to the timely diagnosis of OIN, and strategies for its treatment can be implemented with encouraging results. Identification and modification of risk factors for the development of OIN can help in its prevention and improve the quality of life in advanced cancer patients.