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Acta Anaesthesiologica Scandinavica

Beatriz Planelles, César Margarit, Raquel Ajo, Yolanda Sastre, Javier Muriel, María-Del-Mar Inda, María D Esteban, Ana M Peiró
BACKGROUND: Safety data from long-term opioid therapy in the real world has been poorly studied in chronic non-cancer pain (CNCP). The aim was to design a pharmacovigilance data recording system and assess whether participation in this recording system improves pain management, enhancing patient's health status. METHODS: A pharmacovigilance data recording system was conducted during 24 months. Data were self-reported by patients (pain, adverse events [AEs] and healthcare resources use) and physicians (morphine equivalent daily dose [MEDD] prescribed and suspected adverse drug reaction [ADRs])...
August 14, 2018: Acta Anaesthesiologica Scandinavica
Evelyn Borchert Billik, Guillermo Lema
No abstract text is available yet for this article.
August 14, 2018: Acta Anaesthesiologica Scandinavica
Dorothy A Perry, Lindsay M Thomson, Frank A Pigula, Brian D Polizzotti, James A DiNardo, Arthur Nedder, Kimberlee Gauvreau, John N Kheir
BACKGROUND: Hyperoxemia (arterial oxygen tension >100 mm Hg) may occur in critically ill patients and have effects on mixed venous saturation (SvO2 ) and on Fick-based estimates of cardiac output (CO). We investigated the effect of hyperoxemia on SvO2 and on assessments of CO using the Fick equation. METHODS: Yorkshire swine (n = 14) were anesthetized, intubated, and paralyzed for instrumentation. SvO2 (co-oximetry) and tissue oxygen tension (tPO2 , implantable electrodes) in brain and myocardium were measured during systematic manipulation of arterial oxygen tension (PaO2 ) using graded hyperoxia (fraction of inspired oxygen 0...
August 14, 2018: Acta Anaesthesiologica Scandinavica
Thomas D Nielsen, Bernhard Moriggl, Jeppe Barckman, Jan Mick Jensen, Jens A Kølsen-Petersen, Kjeld Søballe, Jens Børglum, Thomas Fichtner Bendtsen
BACKGROUND: Cutaneous nerve blockade may improve analgesia after hip surgery. Anaesthesia after the lateral femoral cutaneous (LFC) nerve block is too distal for complete coverage of most hip surgery incisions, which requires additional anaesthesia of the adjacent, proximal area. The transversalis fascia plane (TFP) block potentially anaesthetises the iliohypogastric and subcostal nerves. The primary aim of the present study was to investigate, if the TFP block provides cutaneous anaesthesia adjacent to the LFC nerve block...
August 14, 2018: Acta Anaesthesiologica Scandinavica
David A Milder, Neil L Pillinger, Peter C A Kam
INTRODUCTION: Increasing emphasis is being placed on the detection of frailty in the pre-operative setting given its association with surgical morbidity and mortality. Prehabilitation seeks to increase the physiological reserve of frail patients, attenuating the risk of irreversible functional decline following surgery. AIM/HYPOTHESIS: This systematic review appraises the evidence available for prehabilitation in frail surgical patients. We proposed that exercise prehabilitation would especially benefit frail patients, with improvements in pre-operative functional capacity, and reductions in complications and length of hospital stay...
August 10, 2018: Acta Anaesthesiologica Scandinavica
Jens R Eriksen, Pia Munk-Madsen, Henrik Kehlet, Ismail Gögenur
BACKGROUND: Orthostatic hypotension (OH) and intolerance (OI) are common findings in the early postoperative period after major surgery and may delay early mobilization. The mechanism of impaired orthostatic competence and OI symptoms is not fully understood, and specific data after colorectal surgery with well-defined perioperative care regimens and mobilization protocols are lacking. The aim of this study was to investigate the prevalence, possible risk factors and the impact of OI in patients undergoing elective minimal invasive colorectal cancer resection...
August 10, 2018: Acta Anaesthesiologica Scandinavica
Berthold Moser, Christian Keller, Laurent Audigé, Mital H Dave, Heinz R Bruppacher
INTRODUCTION: Airway management in severely obese patients remains a challenging issue for anaesthetists and may lead to life-threatening situations. Supraglottic airway devices, such as the i-gel™ or the AuraGain™, were developed, with the possibility to ventilate the patient or use them as a conduit for endotracheal intubation. METHODS: In our randomized prospective trial, we hypothesized a 10 seconds faster fiberoptic trans-device intubation time through the AuraGain™ laryngeal mask compared to the i-gel™ laryngeal mask in severely obese patients...
August 8, 2018: Acta Anaesthesiologica Scandinavica
Jennifer Herzog-Niescery, Heike Vogelsang, Philipp Gude, Hans-Martin Seipp, Waldemar Uhl, Thomas P Weber, Martin Bellgardt
BACKGROUND: MIRUS™ is a device for target-controlled inhalational sedation in the ICU in combination with use of isoflurane, or sevoflurane, or desflurane. The feasibility of this device has recently been proven; however, ICU staff exposure may restrict its application. We investigated ICU ambient room pollution during daily work to estimate ICU personnel exposure while using MIRUS™. METHODS: This observational study assessed pollution levels around 15 adult surgical patients who received volatile anaesthetics-based sedation for a median of 11 hours...
August 7, 2018: Acta Anaesthesiologica Scandinavica
Timo Jahnukainen, Juho Keski-Nisula
No abstract text is available yet for this article.
August 7, 2018: Acta Anaesthesiologica Scandinavica
François-Pierrick Desgranges, Marine Simonin, Sophie Barnoud, Laurent Zieleskiewicz, Eloise Cercueil, Julien Erbacher, Bernard Allaouchiche, Dominique Chassard, Lionel Bouvet
BACKGROUND: Emergent obstetrical procedures may require general anaesthesia in parturients at full cervical dilatation or immediately after vaginal birth. This study aimed to determine the prevalence and the predictive factors of higher estimated gastric content in parturients at full cervical dilatation with epidural analgesia and allowed to drink during the labour, and to assess the ability of the antral area measured in the semirecumbent position (SR-CSA) to identify higher estimated gastric content in this setting...
August 7, 2018: Acta Anaesthesiologica Scandinavica
Mostafa S Abbas, Khaled S Mohamed, Osama A Ibraheim, Ahmed M Taha, Tameem M Ibraheem, Bashir A Fadel, Abdelraheem Elawamy, Ahmed M Abbas
BACKGROUND: Blood loss and perioperative blood transfusion requirements affect the long-term survival after liver resection for malignant tumours. Terlipressin is a synthetic vasopressin analogue with relative specificity for the splanchnic circulation where it causes vasoconstriction with subsequent reduction of blood loss during abdominal surgeries. We tried to examine the impact of terlipressin on blood loss and blood transfusion needs during liver resection. METHODS: In this randomised, double-blind placebo-controlled trial 84 patients scheduled for major liver resections were randomly assigned to receive either terlipressin at the onset of surgery as an initial bolus dose of (1 mg over 30 minutes) followed by a continuous infusion of 2 μg/kg/h throughout the procedure (Terlipressin group) or the same volume and rate of 0...
August 5, 2018: Acta Anaesthesiologica Scandinavica
Johan Kristansson, Fredrik Olsen, Eva Hagberg, Robert Dutkiewicz, Bengt Nellgård
BACKGROUND: Hip fracture is a common injury in the elderly population and is associated with high morbidity and mortality. Intraoperative hypotension is commonly noted, and is often treated with vasopressors (VP), however, to what extent is unknown. We set out to examine retrospectively how many hip fracture-patients received VP perioperatively and further to investigate if VP treatment is connected to increased mortality. METHOD: Data on VP treatment were captured from medical and anaesthesia journals, and if so, data were investigated to find potential confounders...
August 5, 2018: Acta Anaesthesiologica Scandinavica
Alwin Chuan, Timothy G Short, Alexander Z Y Peng, Shelly Y B Wen, Alice X Sun, Timothy H Ting, Anthony S Wan, Linda Pope, Matthias Jaeger, Anders Aneman
BACKGROUND: Studies have identified multiple risk factors for development of cognitive decline after surgery. Impaired cerebrovascular autoregulation may be a contributor to postoperative cognitive decline. METHODS: One hundred and forty patients admitted for major elective noncardiac surgery were recruited. Near-infrared spectroscopy was used to calculate the tissue oxygenation index of dynamic autoregulation (TOx). The primary endpoint was Day 3 cognitive recovery as assessed using the Postoperative Quality of Recovery Scale...
August 5, 2018: Acta Anaesthesiologica Scandinavica
Kristo Erikson, Tero Ilmari Ala-Kokko, Juha Koskenkari, Janne Henrik Liisanantti, Remi Kamakura, Karl Heinz Herzig, Hannu Syrjälä
BACKGROUND: A high prevalence of delirium is observed in sepsis, yet specific markers for this brain dysfunction in sedated patients are still lacking. Cytoplasmic low molecular weight calcium-binding protein, S-100β, is a commonly used nonspecific marker for brain injury. Here, we evaluated whether delirium is associated with increases in S-100β levels. METHODS: This observational study included 22 patients with septic shock. Delirium was assessed by CAM-ICU and blood samples were obtained to measure inflammatory (CRP, PCT, IL-6, IL-17, TNF-α) and cerebral biomarkers (S-100β, NSE, HAB42, SUBP)...
August 5, 2018: Acta Anaesthesiologica Scandinavica
Mamta Dubey, Amit K Mittal, Jiten Jaipuria, Manisha Arora, Ajay K Dewan, Akhilesh Pahade
BACKGROUND: Transcutaneous laryngeal ultrasound (TCLUS) can assess Vocal folds (VF) by subjectively identifying mobility or objectively by calculating vocal fold displacement velocity (VFDV). Optimal diagnostic approach (subjective assessment, VFDV estimation or a combination of both) is unresolved; hence, we conducted this prospective study in patients undergoing thyroidectomy. METHOD: Two anaesthetists performed TCLUS pre- and post-operatively for functional assessment of 200 VFs on 100 patients...
August 5, 2018: Acta Anaesthesiologica Scandinavica
Joonas I Tamminen, Sanna E Hoppu, Antti J J Kämäräinen
BACKGROUND: Although widely dispatched to out-of-hospital cardiac arrests, the performance of prehospital first-responding units in other medical emergencies is unknown. METHODS: In this retrospective, descriptive study, the general performance of 44 first-responding units in Pirkanmaa County, Finland, were examined. A subgroup analysis compared the first-responding units made up of professional firefighters and trained volunteers. RESULTS: First-responding units were dispatched to patients during 1622 missions between 1 January 2013 and 31 December 2013...
August 1, 2018: Acta Anaesthesiologica Scandinavica
Elke M E Bos, Maartje E Schut, Marcel de Quelerij, Cor J Kalkman, Markus W Hollmann, Philipp Lirk
BACKGROUND: The clinical use of epidural analgesia has changed over past decades. Minimally invasive surgery and emergence of alternative analgesic techniques have led to an overall decline in its use. In addition, there is increasing awareness of the patient-specific risks for complications such as spinal haematoma and abscess. Local guidelines for management of severe neurological complications during or after epidural analgesia, ie, "epidural alert systems", have been introduced in hospitals to coordinate and potentially streamline early diagnosis and treatment...
August 1, 2018: Acta Anaesthesiologica Scandinavica
Anders Granholm, Christian Fynbo Christiansen, Steffen Christensen, Anders Perner, Morten Hylander Møller
BACKGROUND: Severity scores, including the Simplified Acute Physiology Score (SAPS) II, are widely used in the intensive care unit (ICU) to predict mortality outcomes using data from ICU admission or shortly hereafter. For patients with longer ICU length of stay (LOS), the predictive performance of admission-based severity scores may deteriorate compared to patients with shorter ICU LOS. This protocol and statistical analysis plan outlines a study that will assess the influence of ICU LOS on the performance of SAPS II for predicting 90-day post-ICU mortality...
July 31, 2018: Acta Anaesthesiologica Scandinavica
Thomas Drew, Conan McCaul
No abstract text is available yet for this article.
July 31, 2018: Acta Anaesthesiologica Scandinavica
Emilie Katrine Kongebro, Lars N Jorgensen, Volkert D Siersma, Christian Sahlholt Meyhoff
BACKGROUND: Perioperative hyperoxia has been linked to increased long-term mortality. Vasoconstrictive and cellular side effects to hyperoxia have been suggested to increase the risk of coronary and cerebral ischemia. The aim of this post-hoc analysis of a large randomized trial was to compare the effects of 80% vs 30% perioperative oxygen on the long-term risk of stroke or transient cerebral ischemia (TCI) in patients undergoing abdominal surgery. METHODS: A total of 1386 patients were randomized to 80% or 30% perioperative oxygen during acute or elective open abdominal surgery...
July 31, 2018: Acta Anaesthesiologica Scandinavica
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