Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 1998
Randomized Controlled Trial Comparative Study Clinical TrialRespiration during emergence from anaesthesia with desflurane/N2O vs. desflurane/air for gynaecological laparoscopy.
The complications related to anaesthesia usually occur in the early postoperative period. Hypercapnia and hypoxaemia may result from any persistent depression of the respiratory drive relative to the metabolic demand. The purpose of this study was to compare the respiratory effects of desflurane anaesthesia with or without nitrous oxide during the period of emergence. ⋯ The respiratory profiles during recovery from gynaecological laparoscopy with either desflurane/N2O or desflurane anaesthesia were similar with fast resumption of spontaneous breathing, short time to extubation, and no signs of CO2 retention.
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Acta Anaesthesiol Scand · Nov 1998
Randomized Controlled Trial Clinical TrialIs the recovery profile of mivacurium independent of the rate of decay of its plasma concentration in patients with normal plasma cholinesterase activity?
The duration of action of muscle relaxants is poorly correlated to the rate of decay of their plasma concentration. The plasma concentration of mivacurium may rapidly decrease below its active concentration because of the extensive hydrolysis of mivacurium. By inflating a tourniquet on one upper limb for 3 min after the administration of atracurium, mivacurium or vecuronium, we studied the influence of the initial decline of their plasma concentration on their effect. ⋯ The results suggest that the rate of decline of the plasma concentration of mivacurium is so rapid, that a very low and almost clinically ineffective concentration is present as soon as 3 min after its administration. The results also indicate that the recovery from a mivacurium-induced neuromuscular blockade is not influenced by the rate of decay of its plasma concentration in patients with genotypically normal plasma cholinesterase.
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Acta Anaesthesiol Scand · Nov 1998
Effects of recruitment of collapsed lung units on the elastic pressure-volume relationship in anaesthetised healthy adults.
The elastic pressure-volume (Pel-V) curve of the respiratory system can be used as a guide for improved ventilator management. The understanding of curves recorded for sick patients can be improved with better knowledge of the Pel-V relationship observed in healthy humans. Dynamic Pel-V curves were determined over an extended volume range in 15 anaesthetised and muscle-relaxed healthy humans. The influence of a recruitment manoeuvre was studied. ⋯ Pel-V curves recorded before and after the recruitment manoeuvre show that large lung compartments close during anaesthesia and that high pressures are needed to achieve recruitment even in the normal lung. Accordingly, the LIP does not define the end of recruitment during insufflation.
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Acta Anaesthesiol Scand · Nov 1998
Randomized Controlled Trial Comparative Study Clinical TrialSubarachnoid and intravenous PCA versus bolus administration for postoperative pain relief in orthopaedic patients.
Patient-controlled analgesia (PCA) with intravenous piritramide and subarachnoid bupivacaine was studied during postoperative pain management in comparison with nurse-administered bolus injections. ⋯ PCA with CSA was more effective than nurse-administered bolus-administration of bupivacaine, while the present study failed to show superiority of i.v. PCA over i.v. bolus-administration of piritramide. PCA using the subarachnoid route is a promising concept for treatment of postoperative pain in orthopaedic patients, while the PCA piritramide regime of this study warrants improvement.
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Acta Anaesthesiol Scand · Nov 1998
Effect of CPAP during cardiopulmonary bypass on postoperative lung function. An experimental study.
Respiratory failure secondary to cardiopulmonary bypass (CPB) remains a major complication after cardiac surgery. We tested the hypothesis that post-CPB lung function impairment can be prevented by continuous positive airway pressure (CPAP) applied during the CPB. ⋯ We conclude that in this pig model post-CPB atelectasis is not effectively prevented by CPAP applied during CPB.