Articles: monitoring.
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Randomized Controlled Trial Comparative Study Clinical Trial Retracted Publication
Recovery of post-tetanic count and train-of-four responses at the great toe and thumb.
We have studied the recovery of post-tetanic count and train-of-four responses at the great toe and thumb accelerographically after the administration of vecuronium 0.2 mg.kg-1. Sixty adult patients scheduled for anaesthesia with nitrous oxide and isoflurane were studied. The times to the return of the first post-tetanic twitch were comparable at the great toe and thumb (mean (SD) times: 30.0 (6.5) min and 35.0 (8.5) min, respectively). ⋯ Also, time to the return of the first twitch of the train-of-four did not differ significantly at the great toe and the thumb (47.5 (9.6) min vs. 49.7 (10.5) min). Similarly, time to the return of the second, third and fourth twitches of the train-of-four did not significantly differ at the great toe and the thumb. However, the value of the first twitch of the train-of-four, expressed as a proportion of control twitch, was significantly higher than that at the thumb between 50 min and 110 min after the vecuronium injection, and the train-of-four ratio at the great toe was significantly higher than that at the thumb between 60 min and 100 min after the vecuronium injection.
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Ugeskrift for laeger · Feb 1998
Comparative Study[Quantitative EEG in assessment of anesthesia depth. Methods of comparison].
Methodology for assessment of depth of anaesthesia based on analysis of the electroencephalogram (eeg) is controversial. Techniques range from display of single measures, for example median value of the frequency spectrum, to dedicated pattern recognition systems based on measures of several eeg features. We have compared the performance of four techniques using tape-recorded data from 23 patients anaesthetised with either halothane or isoflurane using standardised regimens. ⋯ Dose-response curves are presented for stepwise increases in stable end-tidal concentrations of each agent. Results indicated considerable inter-patient variability and showed the limitations of single eeg measures, particularly with deeper anaesthesia producing burst suppression patterns in the eeg. Pattern recognition techniques reduced these difficulties and appeared to be promising over a wide range of anaesthetic levels.
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This study describes in detail the technique and results of on-line multiplane transesophageal echocardiographic guidance of balloon mitral commissurotomy in 150 consecutive patients with symptomatic mitral stenosis. The mitral valve area improved significantly and there were no in-hospital deaths, strokes, or emergency valve operations.
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J Clin Monit Comput · Feb 1998
Randomized Controlled Trial Comparative Study Clinical TrialComputer aided monitor-data processing (CAMP). A landmark for unbiased gauging of anaesthetic courses?
A computer aided monitor-data processing system (CAMP-System) was developed in order to get a consistent and comprehensive database which can very precisely reflect intra-operative haemodynamic courses. The goal of the present study was to introduce a new method to scan and to gauge haemodynamic courses and to demonstrate its superiority over the traditional way of data processing based on a handwritten anaesthesia protocol. ⋯ Computerized data processing including automatic artifact suppression and data condensation was able to reveal differences in the course of haemodynamic variables that cannot be detected in a conventional handwritten protocol.
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Because overall EMS system response depends on ambulance availability, we conducted a prospective study of the EMS turnaround interval. This interval represents the time elapsed from ambulance arrival at the hospital until the ambulance reports back in service. ⋯ In this system, ambulance call report documentation required the greatest subinterval of turnaround interval. The turnaround interval and its subintervals varied widely, and radio contact times correlated poorly with observed times at the ED. Attempts at improvement of overall system response through active management of the turnaround interval may be frustrated by reliance on radio-reported availability. [Cone DC, Davidson SJ, Nguyen Q: A time-motion study of the emergency medical services turnaround interval. Ann Emerg Med February 1998;31:241-246.].