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| 2. |
- Alkaissi, Aidah, et al.
(författare)
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Effect and placebo effect of acupressure (P6) on nausea and vomiting after outpatientgynaecological surgery
- 1999
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Ingår i: Acta anaesthesiologica Scandinavica. - 0001-5172 .- 1399-6576. ; 43:3, s. 270-274
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Acupuncture and acupressure have previously been reported to possess antiemetic effect. We wanted to investigate the "true" and placebo effect of acupressure in prevention of postoperative nausea and vomiting (PONV). PATIENTS AND METHODS: Sixty women undergoing outpatient minor gynaecological surgery were entered into a double-blind and randomised study. One group received acupressure with bilateral stimulation of P6 (A), a second group received bilateral placebo stimulation (P) and a third group received no acupressure wrist band and served as a reference group (R). PONV was evaluated as number of patients with complete response (no PONV), nausea only or vomiting. In addition, the need for rescue antiemetic medication and nausea after 24 h was registered. RESULTS: Complete response was obtained in 11, 11 and 9 patients in groups, A, P and R, respectively. Nine, 7 and 6 patients had nausea before discharge home, and 1, 1 and 8 patients were nauseated (8 vs 1 patient: P < 0.05) 24 h after operation in A, P and R groups, respectively. When compared to placebo acupressure (2 patients vomited and 5 needed rescue), significantly (P < 0.05) fewer needed rescue antiemetic medication after acupressure at P6 (no vomiting or rescue medication). When compared to the observation group (5 vomited and 4 needed rescue antiemetics), significantly fewer vomited after acupressure (P < 0.05) CONCLUSION: In patients undergoing brief gynaecological surgery, placebo effect of acupressure decreased nausea after 24 h but vomiting and need of rescue antiemetics was reduced only by acupressure with the correct P6 point stimulation.
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| 3. |
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| 4. |
- Arnestad, J P, et al.
(författare)
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Removal of activated complement from shed blood: comparison of high- and low-dilutional haemofiltration.
- 1998
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Ingår i: Acta anaesthesiologica Scandinavica. - 0001-5172. ; 42:7, s. 811-5
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Perioperative blood salvage is associated with release of inflammatory mediators. Depending on type of processing, the complement system is activated to some extent in the final blood product. The aim of the present study was to evaluate a haemofiltration technique concerning complement system activation and whether the volume of added saline will have an influence on the elimination of activated complement during processing. METHODS: Sixteen patients undergoing total hip arthroplasty received wound blood salvaged intraoperatively with a haemofiltration technique. Saline was added to the reservoir for washing in a ratio of 1:1 or 5:1 of estimated blood volume. Samples for determination of the anaphylatoxins C3a and C5a, and the terminal SC5b-9 complement complex (TCC) were drawn from the patients, the collected blood, the ultrafiltrate and the processed blood. RESULTS: Increased concentrations of C3a, C5a and TCC were found in aspirated and processed blood. Haemofiltration did not reduce the concentrations of these factors, except that of C3a in the group where saline was added in a ratio of 5:1. There were no increased concentrations of C3a, C5a or TCC in the patient plasma after reinfusion. No differences in blood pressure, heart rate, pH, arterial oxygen tension, arterial carbon dioxide tension, or base excess were found in association with reinfusion of the blood. CONCLUSION: Collected shed blood washed through haemofiltration contained moderately elevated concentrations of C3a, C5a and TCC. Reinfusion of the blood neither led to increased systemic concentrations of complement activation products, nor to disturbances in haemodynamic or biochemical parameters.
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| 10. |
- Dobrydnjov, Igor, et al.
(författare)
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Enhancement of intrathecal lidocaine by addition of local and systemic clonidine
- 1999
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 43:5, s. 556-562
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Tidskriftsartikel (refereegranskat)abstract
- Background: Enhancement of local anaesthetic-produced regional blocks by clonidine seems well established. There are insufficient data about dose-effect relationship of combinations of clonidine with individual agents, efficiency of local versus systemic administration of clonidine, and comparative evaluation of clonidine with vasoconstrictors. Because of unavailability of long-acting local anaesthetics at the time of study, our aim was to evaluate augmentation of lidocaine spinal block with local or systemic clonidine and to compare the results with the efficacy of intrathecal phenylephrine.Methods: Ninety pts of age 50–72 yrs with ASA 1–4 physical status, scheduled for open prostatectomies, hysterectomies or ostheosynthesis of fractured hip were randomized to one of 6 treatment groups, 15 pts in each. Patients received intrathecally (L3–L4) either 100 mg of plain lidocaine (group L100); or a mixture of lidocaine 40 and 80 mg with clonidine 100 μg (groups L40-C100 and L80-C100); or a combination of lidocaine 40 and 80 mg with clonidine 300 μg orally 60 min before spinal puncture (L40-C300 and L80-C300). Addition of intrathecal phenylephrine 5 mg to 80 mg of lidocaine was also investigated (L80-P5).Results: There were no significant intergroup differences concerning demographic data or type of surgery. All operations (duration up to 150 min) were completed without need for analgesic supplementation. The addition of clonidine resulted in a significant reduction of the onset time of spinal block and prolongation of the duration of sensory and motor blocks compared to plain lidocaine or lidocaine with phenylephrine. In spite of the well-known hypotensive action of α2-agonists, haemodynamic depression only in group L80-C300 was significantly more pronounced than in L100 and L80-P5 groups. The least decrease of BP and minimal need of rescue ephedrine among all patients studied were recorded in the group receiving low dosage of lidocaine with intrathecal clonidine (L40-C100). Sedation occurred in most patients receiving clonidine.Conclusion: Our results indicate that addition of clonidine to lidocaine, irrespective of the route of administration, prolongs the duration of spinal block and permits a reduction of the lidocaine dose needed for a given duration of block. Addition of phenylephrine results in a less pronounced statistically significant prolongation of anaesthesia. The regression of sensory block before restoration of motor function seems to be a specific (and unfortunate) effect of both clonidine and phenylephrine.
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| 11. |
- Eiken, Ola, et al.
(författare)
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Effect of nitrous oxide on human skeletal muscle function
- 1996
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 40:4, s. 486-488
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Nitrous oxide (N2O) is commonly administered in conjunction with parturition, which requires the performance of repeated high-force voluntary muscle actions. Therefore, we examined the effect of a subanesthetic dose of N2O on the force-velocity relationship of the quadriceps femoris muscle. METHODS: Nine healthy subjects performed maximal voluntary muscle actions once while breathing air and once while breathing a normoxic gas mixture containing 35% (N2O). Peak torque of the knee extensors was measured during concentric muscle contractions at different angular velocities (30, 60, 90, 150 and 210 degrees s-1), and eccentric (30, 60, 90, and 150 degrees s-1) and isometric (knee-joint angle approximately equal to 60 degrees) muscle actions. Maximal angular velocity was determined during unloaded knee extensions. RESULTS: N2O decreased peak torque at any given angular velocity. The overall decrease in peak averaged 4.8 +/- 2.2% (P < 0.0001). Likewise, N2O decreased maximal angular velocity by 5.7 +/- 4.3% (P < 0.01). Thus, the impairment in muscle function induced by a 35% N2O is only minute and hence most likely of little significance in clinical practice.
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| 12. |
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| 13. |
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| 14. |
- Ekbäck, Gustav, et al.
(författare)
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Perioperative autotransfusion and functional coagulation analysis in total hip replacement
- 1995
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 39:3, s. 390-395
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Tidskriftsartikel (refereegranskat)abstract
- Functional coagulation analyses like Sonoclot and thromboelastography have not been evaluated during perioperative autotransfusion. We have prospectively studied three different transfusion regimes in 45 patients undergoing total hip arthroplasty. Blood losses were replaced either with heterologous erythrocyte concentrate (group I), intra- and postoperative autotransfusion of blood salvaged with cellsaver technique (group II) or predonated autologous erythrocyte concentrates together with salvaged blood (group III). Routine and functional coagulation analyses with a Sonoclot were performed preoperatively, 6 hours postoperatively (6 h), day 1–5 and 10. An early postoperative hypo- and late postoperadve hypercoagulative phase could be detected with Sonoclot signs of platelet function and fibrin deposition in all groups. Sonoclot coagulation analyses better correlated to both blood loss and dextran dosage than APTT and platelet count in the routine coagulation analyses. Functional coagulation analysis has a potential use in individualizing plasmasubstitution and thromboprophylaxis regimes during autotransfusion in THR.
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| 15. |
- EKLUND, J
(författare)
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PROPER AND ACCURATE USE OF REFERENCES
- 1995
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Ingår i: ACTA ANAESTHESIOLOGICA SCANDINAVICA. - : Wiley. - 0001-5172 .- 1399-6576. ; 39:5, s. 575-576
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 16. |
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| 17. |
- Eriksson, LI, et al.
(författare)
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Fasting guidelines in different countries
- 1996
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Ingår i: Acta anaesthesiologica Scandinavica. - : Wiley. - 0001-5172. ; 40:88 Pt 2, s. 971-974
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Tidskriftsartikel (refereegranskat)
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| 18. |
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| 19. |
- Eriksson, L
(författare)
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Should a neuromuscular block be reversed?
- 1997
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Ingår i: Acta anaesthesiologica Scandinavica. Supplementum. - : Wiley. - 0515-2720 .- 0001-5172. ; 110, s. 101-
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Tidskriftsartikel (refereegranskat)
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| 20. |
- Eriksson, Mats, et al.
(författare)
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Increased platelet microvesicle formation is associated with mortality ina porcine model of endotoxemia
- 1998
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 42:5, s. 551-557
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Tidskriftsartikel (refereegranskat)abstract
- Background:Gram-negative sepsis in humans and endotoxemia in pigs induce the formation of platelet microvesicles. These microvesicles are active in homeostasis and may thus contribute to the outcome in patients with activated coagulation and fibrinolysis. We decided to prospectively evaluate the effects of endotoxemia on microvesicle formation and some common physiologic variables against survival in a porcine model.Methods:Nineteen included pigs were anesthetized, monitored and subjected to an infusion of E. coli endotoxin. Microvesicle formation was determined by flow cytometry.Results:The formation of microvesicles was significantly increased in the 6 pigs that died during endotoxin exposure. This increased formation became significant from the 3rd hour of endotoxemia. Microvesicle formation did not increase in surviving endotoxemic pigs. Cardiac index, mean arterial blood pressure, base excess and systemic vascular resistance index were distinctly reduced in the animals that died as compared to those surviving the endotoxemic period.Conclusion:The increased formation of platelet microvesicles seems to be associated with poor prognosis in porcine endotoxemia. Since microvesicles are active in coagulation, they may contribute to the derangement of the coagulation system caused by endotoxemia. Different degrees of microvesicle formation may reflect inter-individual responses to a given challenge.
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| 21. |
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| 22. |
- Erlandsson, Marcus, et al.
(författare)
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Surveillance of Antibiotic Resistance in ICUs in Southeastern Sweden
- 1999
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Ingår i: Acta Anaesthesiol Scand. - : Wiley. ; 43:8, s. 815-820
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Tidskriftsartikel (refereegranskat)abstract
- Background: A study was designed to assess a computer-based program for continuous registration of antibiotic resistance, statistics concerning severity of illness, and consumption of antibacterial drugs. Methods: The frequency of antibiotic resistance among bacteria in eight ICUs in southeastern Sweden was investigated yearly from 1995 through 1997. The antibiotic consumption in the ICUs was registered as defined daily doses (DDD) and compared to severity of illness (APACHE-II scores). Results: There was a statistically significant increase in ampicillin resistance among Enterococcus spp. between 1996 and 1997, which was due to a shift from Enterococcus faecalis to Enterococcus faecium. A high prevalence of resistance among coagulase-negative staphylococci to oxacillin (≈ 70%), ciprofloxacin (≈ 50%), fucidic acid (≈ 50%) and netilmicin (≈ 30%) was seen in all ICUs during the whole study period. There was a statistically significant increase in ciprofloxacin resistance among Escherichia coli and Enterococcus spp. The resistance among Enterobacter spp. to cefotaxime decreased but this change was not statistically significant. Efforts were made to avoid betalactam antibiotics, except carbapenems, for treatment of infections caused by Enterobacter spp. and the consumption of cephalosporins decreased whereas the consumption of carbapenems increased. The total antibiotic consumption decreased by 2.5% during the study period. There was no correlation between APACHE II scores and antibiotic consumption. Conclusions: Each ICU within a hospital ought to have a program for "on-line" antibiotic resistance surveillance of drugs used in that unit so that changes in empirical treatment can be made when there is an increase in antibiotic-resistant isolates within that unit.
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| 24. |
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| 25. |
- FROSTELL, CG
(författare)
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BACKGROUND OF NITRIC-OXIDE INHALATION
- 1995
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Ingår i: ACTA ANAESTHESIOLOGICA SCANDINAVICA. - : Wiley. - 0001-5172 .- 1399-6576. ; 39, s. 58-59
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 26. |
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| 27. |
- Gannedahl, Per E., et al.
(författare)
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Minimal influence of anaesthesia and abdominal surgery on computerized vectorcardiography recordings
- 1995
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Elsevier. - 0001-5172 .- 1399-6576. ; 39:1, s. 71-78
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Tidskriftsartikel (refereegranskat)abstract
- Myocardial infarction still represents a major cause of morbidity and mortality following surgical procedures. Continuous computerized on‐line vector‐ECG has previously been shown to be useful in the detection of myocardial ischaemia, in acute myocardial infarction and unstable angina pectoris and for ischaemia monitoring after PTCA procedures. This method was presently tested for the possible influence of anaesthesia and surgery during cholecystectomy under general anaesthesia (n = 9), and during inguinal hernia repairs using a spinal block (n = 5). The patients had no history, symptoms or signs of ischaemic heart disease. Analyses of vectorcardiographic changes were made in relation to predefined standardized anaesthetic and surgical procedures, all of which potentially could influence the vector‐ECG. Three vectorcardiographic trend parameters were studied: QRS‐vector difference, ST‐vector magnitude and ST‐change vector magnitude. The overall vectorcardiographic changes were minimal and smaller than vectorcardiographic changes previously reported during myocardial ischaemia and infarction. Since anaesthetic and surgical procedures per se had only minor effects on the vector ECG recordings, it is concluded that continuous computerized on‐line vectorcardiography will not be skewed by these procedures. Hence, vectorcardiography has the potential of becoming a new monitor for the detection of perioperative myocardial ischaemia.
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| 28. |
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| 29. |
- Gannerdahl, Per E., et al.
(författare)
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Vectorcardiographic changes during laparoscopiccholecystectomy may mimic signs of myocardial ischaemia
- 1997
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Ingår i: Acta Anaesthesiologica Scandinavica. - : Elsevier. - 0001-5172 .- 1399-6576. ; 41:9, s. 1187-1192
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Tidskriftsartikel (refereegranskat)abstract
- Laparoscopic surgery involves the use of intra-abdominal carbon dioxide insufflation (pneumoperitoneum). The increased intra-abdominal pressure causes marked haemodynamic changes, which may influence electrocardiographic monitoring. The aim of the present study was to elucidate the influence of pneumoperitoneum on vectorcardiographic recordings.METHODS:Vectorcardiographic changes (QRS vector difference = QRS-VD, QRS loop area, QRS magnitude, ST vector magnitude, spatial ST vector change) were recorded continuously applying computerized vectorcardiography in 12 anaesthetised cardiovascularly healthy patients, scheduled for laparoscopic cholecystectomy. Measurements were made before and during pneumoperitoneum in three different body positions (supine, Trendelenburg and reversed Trendelenburg), also employing transesophageal echocardiography and invasive blood pressure monitoring.RESULTS:Pneumoperitoneum significantly increased QRS-VD, in parallel with an enlargement in loop area and magnitude. The magnitude was significantly increased in the transversal and frontal planes and there was a tendency to increase the magnitude in the sagittal plane. The increase in QRS-VD reached levels previously associated with the development of myocardial ischaemia in patients with coronary artery disease. The ST-variables were not changed by the pneumoperitoneum. The positional changes also influenced QRS-VD significantly.CONCLUSIONS:When computerized vectorcardiography is used for ischaemia monitoring during pneumoperitoneum, the ST-variables seem reliable. However, vectorcardiographicQRS-changes should be interpreted with caution, as the QRS alterations found during pneumoperitoneum mimic the changes seen during myocardial ischaemia.
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| 30. |
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| 31. |
- Gordh, T
(författare)
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How anaesthesiology came to Sweden
- 1998
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Ingår i: Acta anaesthesiologica Scandinavica. Supplementum. - : Wiley. - 0515-2720 .- 0001-5172 .- 1399-6576. ; 42113, s. 34-38
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Tidskriftsartikel (refereegranskat)
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| 32. |
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| 33. |
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| 34. |
- Hahn, RG
(författare)
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Adenosine and isoflurane concentrations
- 1997
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Ingår i: Acta anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 41:9, s. 1226-1226
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 35. |
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| 37. |
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| 38. |
- Hahn, RG
(författare)
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Is glycine a safe irrigating fluid?
- 1997
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Ingår i: Acta anaesthesiologica Scandinavica. - : Wiley. - 0001-5172 .- 1399-6576. ; 41:4, s. 545-545
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 39. |
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| 40. |
- Hahn, R
(författare)
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Thermodilution in medicine
- 1997
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Ingår i: Acta anaesthesiologica Scandinavica. Supplementum. - : Wiley. - 0515-2720 .- 0001-5172. ; 110, s. 137-
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Tidskriftsartikel (refereegranskat)
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| 41. |
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| 44. |
- Holmström, Anders, et al.
(författare)
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Fibreoptic laryngotracheoscopy via the laryngeal mask airway in children
- 1997
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Ingår i: Acta Anaesthesiologica Scandinavica. - 0001-5172. ; 41:2, s. 239-241
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Fibreoptic laryngotracheoscopy via the laryngeal mask airway-previously reported in adults but not in children-gives a better endoscopic view of the upper airway than does endoscopy via an endotracheal tube. METHOD: The endoscopic procedure was carried out via a size 2 laryngeal mask in 4 spontaneously breathing children between 1 and 6 years old. Anaesthesia was induced and maintained with halothane in 50-100% oxygen. RESULTS: The laryngeal mask was found to enable laryngotracheoscopy with a flexible 5.0-mm fibreoptic endoscope with no technical difficulties. Spontaneous ventilation could be readily preserved throughout the endoscopic procedure. CONCLUSIONS: In children anaesthetized with halothane, flexible fibreoptic laryngotracheoscopy via a laryngeal mask is a useful method-offering technical advantages not achieved otherwise-provided that generally approved restrictions to the use of a laryngeal mask airway are taken into account.
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