Folia medica Cracoviensia
-
Folia medica Cracoviensia · Jan 2001
Arterial to end-tidal carbon dioxide difference during craniotomy in severely head-injured patients.
Clinical data suggest that cerebral blood flow (CBF) can be abnormally low within the first four to eight hours after severe head injury (SHI). An aggressive hyperventilation can additionally worsen CBF and provoke cerebral ischemia. Therefore an accurate PCO2 monitoring in SHI patients (pts) is necessary. ⋯ No relationships between P(a-et)CO2 and pts age and mean arterial pressure were found. P(a-et)CO2 was higher in normocapneic pts than in hyperventilated ones and tended to decrease with an increase in heart rate. We can conclude that during an acute craniotomy in SHI pts, PetCO2 does not reflect accurately PaCO2 and the monitoring of adequacy of ventilation should be based on repeated or continuous measurements of an arterial PCO2.
-
Folia medica Cracoviensia · Jan 2001
[Reasons for optimizing perioperative anesthesia methods in neurosurgical patients--personal observations and innovations].
Own observations and experiments in neuroanaesthesia were presented, some of them controversial and in present day even historical, other put into practice for safety and comfort of patients and neurosurgical team.
-
Folia medica Cracoviensia · Jan 2001
[Presence of the trace elements from carbon dioxide absorbent containing lime using a circular apparatus during general anesthesia. ].
The aim of the study was to evaluate release of the trace elements from carbon dioxide absorbent containing soda lime during general anesthesia. We compared two suppliers Polish "Polfa" and German "Dräger". Following trace elements were evaluated: chromium, copper, zinc, cadmium, lead, nickel in soda lime. ⋯ Values of P < 0.05 were consider significant. We concluded that there were no statistically significant differences between examined groups. Thus, we can say that trace elements were not released from soda lime and concentrations of examined elements in patients' blood were not affected by general anesthesia.
-
Folia medica Cracoviensia · Jan 2001
[Patient satisfaction with anesthesia as a measure of quality of anesthesia care].
Patient satisfaction with anaesthesia is very important as a expectancy satisfaction in perioperative care. It is simultaneously patient opinion about the anaesthetic care prior to and during anaesthesia, and shortly after the operation. The aim of the research was to evaluate the patient satisfaction and to determine the factors connected with satisfaction in the perioperative period Out of a total of 250 patients, 155 women (62%) and 95 men (48%) underwent general and local anaesthesia due to the operations. ⋯ The factors decreased patient satisfaction immediately after the operation were breathing difficulties, vomiting, nausea, feeling coldness and pain. The main factors evaluating the quality of anaesthetic care and patient satisfaction are specific information, proper premedication and feeling safety in the operating room. On the other hand the discomfort and insufficient analgesia decreased patient satisfaction with anaesthesia.
-
Folia medica Cracoviensia · Jan 2001
Clinical Trial[Levels of troponin I, tropoinin T, isoenzyme MB creatine kinase and myoglobins in blood serum for perioperative diagnosis of myocardial infarction in patients after coronary artery bypass graft surgery with extracorporeal circulation].
We studied plasma levels of troponin I (cTnI), troponin T (cTnT), creatine kinase MB (CKMBmass) and myoglobin (MB) in patients undergoing coronary artery bypass surgery with extracorporeal circulation and cardioplegia. In group 1 (25 patients without perioperative myocardial infarction) plasma levels of all markers studied were elevated after operation. In group 2 (24 patients with perioperative myocardial infarction) plasma concentrations of all markers exceeded several times levels observed in patients without myocardial infarction with maximal value for MB at 12 hours after operation; for cTnI and CKMBmass at 16 hours after surgery and for cTnT at 32 hours after the end of operation. ROC curves show cut-off value for CKMBmass 20.3 ng/ml (sensitivity 79% and specificity 89%); for cTnI cut-off value was 0.8 ng/ml (sensitivity 80% and specificity 94%) for cTnT the cut-off value was 0.41 ng/ml (sensitivity 86% and specificity 88%) and for MB the cut-off value was 419 ng/ml (sensitivity 85% and specificity 70%). ⋯ All markers studied are reliable biochemical tests for perioperative myocardial infarction, however, the analysis of ROC curves suggested that cTnI and cTnT might be more useful for diagnosis of perioperative myocardial infarction after conventional coronary artery bypass surgery.