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Acta Anaesthesiologica Scandinavica

A Ammar, K Mahmoud, Z Kasemy
BACKGROUND: Various adjuvants have been tried to improve quality and increase duration of local anaesthetics during various nerve blocks. We aimed to evaluate the effect of adding midazolam to bupivacaine on rectus sheath (RS) block in patients undergoing umbilical or epigastric hernia repair. METHODS: In all, 60 adult patients were divided into two equal groups, each group included 30 patients. Group I received 20 ml of bupivacaine hydrochloride 0.25% + midazolam 50 μg/kg in 2 ml saline 0...
February 14, 2018: Acta Anaesthesiologica Scandinavica
M Barbateskovic, S R Kraus, M O Collet, O Mathiesen, J C Jakobsen, A Perner, J Wetterslev
BACKGROUND: In the intensive care unit, the prevalence of delirium is high. Delirium has been associated with morbidity and mortality including more ventilator days, longer intensive care unit stay, increased long-term mortality, and cognitive impairment. Thus, the burden of delirium for patients, relatives, and societies is considerable. The objective of this systematic review was to critically access the evidence of randomised clinical trials on the effects of haloperidol vs. placebo or any other agents for delirium in critically ill patients...
February 14, 2018: Acta Anaesthesiologica Scandinavica
C Wang, H Zhang, Q Fu
BACKGROUND: The median effective dose (ED50 ) of sedative dexmedetomidine adjuvant to peripheral nerve block (PNB) has not yet been verified in elderly patients. This study assessed the ED50 of intravenous dexmedetomidine for sedation in elderly patients who were undergoing total knee arthroplasty (TKA) with PNB. METHODS: Forty-two patients aged 65-85 years were included and stratified into two groups according to age: young-old group (aged 65-74 years) and middle-old group (aged 75-85 years)...
February 9, 2018: Acta Anaesthesiologica Scandinavica
H S Abdel-Ghaffar, S M Moeen
BACKGROUND: The serotonergic system is known to be involved in control of post-anesthetic shivering. Our hypothesis was that prophylactic granisetrone (serotonin antagonist) might reduce incidence of post- spinal anesthesia shivering in cesarean section. METHODS: Parturient scheduled for elective Caesarean delivery under spinal anesthesia were allocated to receive 0.9% saline (Group I, n = 71), 1 mg granisetron (Group II, n = 69), or 0.7 mg granisetron (Group III, n = 72) before the spinal block...
February 8, 2018: Acta Anaesthesiologica Scandinavica
S Lyckner, I-L Böregård, E-L Zetterlund, M S Chew
BACKGROUND: Quality of recovery (QoR) after surgery is often focused on morbidity, mortality and physiological changes, while well-being and emotional state are other important aspects that are often ignored. QoR is poorly investigated in clinical settings and a psychometrically tested questionnaire, QoR-15, has recently been developed. QoR-15 has not been validated for Swedish conditions. The aim of this study was to translate, adapt and validate QoR-15 to Swedish conditions (QoR-15swe)...
February 7, 2018: Acta Anaesthesiologica Scandinavica
V A Eley, A Chin, I Tham, J Poh, P Aujla, E Glasgow, H Brown, K Steele, L Webb, A van Zundert
BACKGROUND: Management of labor epidurals in obese women is difficult and extension to surgical anesthesia is not always successful. Our previous retrospective pilot study found epidural extension was more likely to fail in obese women. This study used a prospective cohort to compare the failure rate of epidural extension in obese and non-obese women and to identify risk factors for extension failure. METHODS: One hundred obese participants (Group O, body mass index ≥ 40 kg/m2 ) were prospectively identified and allocated two sequential controls (Group C, body mass index ≤ 30 kg/m2 )...
February 4, 2018: Acta Anaesthesiologica Scandinavica
J K Jensen, L Dyre, M E Jørgensen, L A Andreasen, M G Tolsgaard
BACKGROUND: Point-of-care ultrasonography plays an increasingly important role in the initial resuscitation of critically ill patients but acquisition of the skill is associated with long learning curves. The skills required to perform ultrasound examinations can be practiced in a simulated setting before being performed on actual patients. The aim of this study was to investigate the learning curves for novices training the FAST protocol on a virtual-reality simulator. METHODS: Ultrasound novices (N = 25) were instructed to complete a FAST training program on a virtual-reality ultrasound simulator...
February 1, 2018: Acta Anaesthesiologica Scandinavica
Y Z Han, Y Tian, H Zhang, Y Q Zhao, M Xu, X Y Guo
BACKGROUND: We identified the most useful variables for prediction of difficult laryngoscopy in patients with cervical spondylosis according to physical indicators and preoperative skeletal X-ray and soft tissue MRI measurements. We hypothesized that there was a closer association between difficult laryngoscopy and radiologic indicators. METHODS: We randomly enroled 315 patients undergoing elective cervical spine surgery and analysed the radiological and physical data in predicting difficult laryngoscopy...
January 31, 2018: Acta Anaesthesiologica Scandinavica
C Ferrando, G Tusman, F Suarez-Sipmann, I León, N Pozo, J Carbonell, J Puig, E Pastor, E Gracia, A Gutiérrez, G Aguilar, F J Belda, M Soro
BACKGROUND: We conducted this study to test whether pulse-oximetry hemoglobin saturation (SpO2 ) can personalize the implementation of an open-lung approach during laparoscopy. Thirty patients with SpO2  ≥ 97% on room-air before anesthesia were studied. After anesthesia and capnoperitoneum the FIO2 was reduced to 0.21. Those patients whose SpO2 decreased below 97% - an indication of shunt related to atelectasis - completed the following phases: (1) First recruitment maneuver (RM), until reaching lung's opening pressure, defined as the inspiratory pressure level yielding a SpO2 ≥ 97%; (2) decremental positive end-expiratory (PEEP) titration trial until reaching lung's closing pressure defined as the PEEP level yielding a SpO2  < 97%; (3) second RM and, (4) ongoing ventilation with PEEP adjusted above the detected closing pressure...
January 29, 2018: Acta Anaesthesiologica Scandinavica
Y Zou, L Shao, M Tian, Y Zhang, F Liu
BACKGROUND: The purpose of this study was to determine the maximum tolerated dose (MTD, the dose of causing 10% respiratory depression) of intranasal sufentanil (SUF) and midazolam (MID) for sedation during gastroscopy by continual reassessment method (CRM). METHODS: Patients (18-65 years old) scheduled for gastroscopy were recruited in this study. Subjects received intranasal SUF and MID for sedation. The dose of MID (5 mg) was fixed, while the dose of SUF was increased progressively (six incremental doses ranging from 0-0...
January 29, 2018: Acta Anaesthesiologica Scandinavica
N Karimian, M Moustafa, J Mata, A K Al-Saffar, P M Hellström, L S Feldman, F Carli
BACKGROUND: Pre-operative complex carbohydrate (CHO) drinks are recommended to attenuate post-operative insulin resistance. However, many institutions use simple CHO drinks, which while convenient, may have less metabolic effects. Whey protein may enhance insulin release when added to complex CHO. The aim of this study was to compare the insulin response to simple CHO vs. simple CHO supplemented with whey protein. METHODS: Twelve healthy volunteers participated in this double-blinded, within subject, cross-over design study investigating insulin response to simple CHO drink vs...
January 28, 2018: Acta Anaesthesiologica Scandinavica
R Haniffa, A Beane, T Baker, E D Riviello, C O Schell, A M Dondorp
No abstract text is available yet for this article.
January 24, 2018: Acta Anaesthesiologica Scandinavica
E-M Ringvold, M Bekkevold, A-M G Bruun, W B Børke, T J Finjarn, A S Haugen, E Isern, G W Skjeflo, A Ulvik
No abstract text is available yet for this article.
January 24, 2018: Acta Anaesthesiologica Scandinavica
M A Rose, J Anderson, S L Green, J Yun, S L Fernando
BACKGROUND: Investigation of immediate hypersensitivity reactions in the perioperative setting involves skin testing and measurement of specific IgE (sIgE) as standard practice. In the case of the neuromuscular blocking agents (NMBAs), the main allergenic epitopes have been shown to be substituted ammonium groups. Commercial assays are available for detection of sIgE to these epitopes using morphine and pholcodine substrates but questions have been raised about the effectiveness of these assays in the diagnosis of benzylisoquinoline anaphylaxis...
January 24, 2018: Acta Anaesthesiologica Scandinavica
S Pekanoja, M Hoikka, H Kyngäs, S Elo
BACKGROUND: In Finland, approximately 40% of emergency medical service (EMS) missions do not result in transport of the patient to a hospital by ambulance, and there is wide variability in the reasons underlying non-transport decisions. The aim of this study was to describe the context of these EMS non-transport missions. METHODS: The data were collected retrospectively between 3 September and 20 October 2014 by investigating non-transport EMS charts (n = 1154)...
January 24, 2018: Acta Anaesthesiologica Scandinavica
A Palazón-Bru, F Colomina-Climent, C Dólera-Moreno, D M Folgado-de la Rosa, V F Gil-Guillén
No abstract text is available yet for this article.
January 24, 2018: Acta Anaesthesiologica Scandinavica
M-H Li, Z-Z Xu, S-M Huang, T Li, X-Y Li, D-X Wang
BACKGROUND: Regional anaesthesia may have advantages in preserving immune function. Tumor-infiltrating lymphocytes (TILs) are considered indicators of immune response in the tumor microenvironment and used as a prognostic marker in patients after cancer surgery. This study investigated the effects of combined epidural anaesthesia on the number of TILs in patients undergoing surgery for lung adenocarcinoma. METHODS: Patients undergoing radical resection for primary lung cancer were randomized to receive either combined epidural-general anaesthesia (Epi-GA) or general anaesthesia (GA) in an ongoing randomized controlled trial (ChiCTR-TRC-14004136)...
January 23, 2018: Acta Anaesthesiologica Scandinavica
E Wallin, I-M Larsson, M-L Kristofferzon, E-M Larsson, R Raininko, S Rubertsson
BACKGROUND: Magnetic resonance imaging (MRI) of the brain including diffusion-weighted imaging (DWI) is reported to have high prognostic accuracy in unconscious post-cardiac arrest (CA) patients. We documented acute MRI findings in the brain in both conscious and unconscious post-CA patients treated with target temperature management (TTM) at 32-34°C for 24 h as well as the relation to patients' neurological outcome after 6 months. METHODS: A prospective observational study with MRI was performed regardless of the level of consciousness in post-CA patients treated with TTM...
January 23, 2018: Acta Anaesthesiologica Scandinavica
K Scholtz, C D Spies, R Mörgeli, R Eckardt, V von Dossow, S Braun, J Sehouli, M Bahra, C G Stief, K-D Wernecke, M Schmidt
BACKGROUND: The aim was to analyse the association between severity of complications up to 30 days after surgery and pre-operative nutritional and physical performance parameters. METHODS: The participants were a subsample of the previously published PERATECS study ( NCT01278537) and included 517 onco-geriatric patients aged ≥ 65 years, undergoing thoracoabdominal, gynaecological, or urological surgery. Post-operative complications were classified according to the Clavien Classification System (CCS)...
January 22, 2018: Acta Anaesthesiologica Scandinavica
A Granholm, A Perner, A K G Jensen, M H Møller
No abstract text is available yet for this article.
January 22, 2018: Acta Anaesthesiologica Scandinavica
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