DP - 2002 Dec
TI - EEG monitoring improves quality and safety of TIVA.
SO - Anaesth Intensive Care 2002 Dec;30(6):817-8.
DP - 2002 Dec
TI - Awareness under TIVA.
SO - Anaesth Intensive Care 2002 Dec;30(6):816.
DP - 2002 Dec
TI - Spinal 5% heavy lignocaine.
SO - Anaesth Intensive Care 2002 Dec;30(6):814-5.
DP - 2002 Dec
TI - The LMA, elective tracheostomy and nasopharyngeal carcinoma.
SO - Anaesth Intensive Care 2002 Dec;30(6):813.
DP - 2002 Dec
TI - Appropriate size of laryngeal mask airway for children.
PG - 771-4
AB - The aim of this crossover study was to determine the optimal size of
laryngeal mask airway in children weighing 10 to 20 kg. In each of 67
apnoeic anaesthetized children, the size 2 and size 2 1/2 laryngeal mask
airways were inserted consecutively by a skilled user and the cuff
inflated to 60 cmH2O. Each LMA was assessed for the ease of insertion (by
the number of attempts), oropharyngeal leak pressure, anatomical position
(assessed fibreoptically) and the volume of air required to achieve
intracuff pressure of 60 cmH2O. During the measurement of oropharyngeal
leak pressure, the airway pressure was not allowed to exceed 30 cmH2O.
There was no failed attempt at insertion with any size. The oropharyngeal
leak pressure was significantly less for the size 2 LMA compared to the
size 2 1/2 LMA (P < 0.001). The oesophagus was visible on three occasions,
all with the size 2 LMA. Gastric insufflation occurred in three patients,
all with the size 2 LMA. The incidence of low oropharyngeal leak pressure
(< 10 cmH2O) was low (9.0%) and all occurred with the size 2 LMA. The
fibreoptic bronchoscope scores were not significantly different between
the two sizes of LMAs. The volume of air to achieve intracuff pressure of
60 cmH2O was much lower than the maximum recommended volume (5.1 ml for
size 2 and 6.2 ml for size 2 1/2). We conclude that the size 2 1/2 LMA
provides a better fit than size 2 in children 10 to 20 kg.
AD - Department of Paediatric Anaesthesia, KK Women's and Children's Hospital,
100 Bukit Timah Road, Singapore 229899.
SO - Anaesth Intensive Care 2002 Dec;30(6):771-4.
DP - 2002 Dec
TI - Reflex responses to insertion of the intubating laryngeal mask airway,
intubation and removal of the ILMA.
PG - 766-70
AB - We studied 21 patients (ASA 1 or 2) to investigate the skin vasomotor
reflex (SVmR) and haemodynamic responses to insertion of an intubating
laryngeal mask airway (ILMA), tracheal intubation using the ILMA and
removal of the ILMA. Anaesthesia was induced with fentanyl, midazolam,
vecuronium and nitrous oxide. A size 4 ILMA was inserted using the
standard technique, and a silicone reinforced tracheal tube (7.5 mm, ID)
was passed through it. After confirming successful intubation, the ILMA
was removed using the stabilizing rod. The three procedures were performed
at approximately one-minute intervals. Insertion of the ILMA, intubation
and removal of the ILMA all significantly reduced the skin blood flow on
the ring finger in all patients. The mean amplitudes of the SVmR were 0.46
(SD 0.29), 0.54 (0.32) and 0.68 (0.21) respectively. The magnitude of the
SVmR and the haemodynamic changes induced by removal of the ILMA were
significantly larger than those accompanying the other two procedures. Use
of the ILMA for intubation and removal of the ILMA produces three stimuli
and the removal of the ILMA produces the greatest response.
AD - Department of Anesthesiology, Kumamoto University School of Medicine,
1-1-1 Honjo, Kumamoto 860-8556, Japan.
SO - Anaesth Intensive Care 2002 Dec;30(6):766-70.
DP - 2003 Mar
TI - [Point-of-care testing of hemostatic alterations in anaesthesia and
intensive care]
PG - 229-37
AB - In recent years point-of-care testing (POCT) has seen wider applications
in the clinical management of surgical and critically ill patients. The
available methods for haemostasis analysis include simple-to-handle tests
for the assessment of plasmatic coagulation, platelet function tests and
the more complex visco-elastic assays.The main advantage of POCT is the
fast availability of the results allowing a targeted management of
haemostasis disorders.The benefits and risks of POCT depend on the urgency
of the analysis, the turn-around time of the laboratory tests, the
availability of motivated staff at the point-of-care and the expected
haemostatic alterations.An underestimated aspect of POCT is the importance
of established quality management procedures.For this purpose control
materials based on plasma or artificial fluids are being applied. In spite
of often higher costs we appraise the use of POC analysis in many settings
as justified because of the gain of time and the overall better process
quality, i.e. targeted haemostasis therapy instead of consecutive
application of different therapeutic options.
AD - Hamostaseologie und Transfusionsmedizin, Klinikum der Universitat Munchen.
SO - Anaesthesist 2003 Mar;52(3):229-37.
DP - 2003 Mar
TI - [Failed spinal analgesia after a combined spinal epidural anaesthesia
for
Caesarean section]
PG - 224-8
AB - A case of failed spinal analgesia with a combined spinal epidural
anaesthesia (CSE) for Caesarean section is described.The lack of desired
effect following an inconspicuous spinal, epidural or combined regional
anaesthesia by an experienced anaesthetist is a rare and unexpected event.
Especially when repeatedly observed in one patient,one should consider
modified anatomical conditions of the affected spinal regions.We discuss
the differential diagnosis which consists of inherent and acquired
modification of tissue, neoplasia and vascular or infectious diseases.This
case also confirms that not every adverse event after spinal or extradural
anaesthesia is necessarily caused by the puncture.
SO - Anaesthesist 2003 Mar;52(3):224-8.
DP - 2003 Jan
TI - [Endotracheal intubation in pediatrics. With or without the cuff?]
SO - Anaesthesist 2003 Jan;52(1):81-2; author reply 82-3.
DP - 2003 Jan
TI - [General H1-H2-blockade for anesthesia induction. Commentary on an article
in Der Anasthesist (2002) 51:420-421]
SO - Anaesthesist 2003 Jan;52(1):79-80.
DP - 2003 Jan
TI - [The management of anaesthesia in hepatic resection and cryosurgery of
the
liver]
SO - Anaesthesist 2003 Jan;52(1):89-96, quiz 96-7.
DP - 2003 Jan
TI - [Unintentional bupivacaine injection in i.v. regional anesthesia]
PG - 84-6
AD - Klinik fur Anasthesiologie und Intensivemedizin, Universttatsklinikum
Carl-Gustav-Carus, TU Dresden. rainer.litz@mailbox.tu-dresden.de
SO - Anaesthesist 2003 Jan;52(1):84-6.
DP - 2003 Jan
TI - [Suicide attempt with high-dose ecstasy]
PG - 51-4
AB - The case of a 16-year-old female patient is reported, who has taken in
30
tablets of Ecstasy in a suicide attempt.Initially were seen a
tachycardia,hyperdynamic circulation, dehydration, leg-myocloni in the
awake excited female patient.For prophylaxis of aspiration general
anaesthesia and intubation with following gastric lavage were performed.
During the intensive care treatment the high blood pressure persisted,
although general anaesthesia and anti-hypertensive therapy was
continued.After extubation the neurologic status of the patient was
normal. Emergency physicians see more and more often
Ecstasy-intoxications.Signs of an acute intoxication with Ecstasy are a
sympathomimetic reaction with tachycardia,hypertonic blood pressure and
cardiac arrhythmia as well as fever, respiratory and renal insufficiency,
rhabdomyolysis, cerebral edema and convulsion. A specific antidote does
not exist; the symptomatic therapy consists of airway management,
hemodynamic stabilisation, primary drug-elimination and, in case of need,
application of betablockers and relaxants.
AD - Institut fur Anasthesiologie und Operative Intensivmedizin,
Universitatsklinikum Mannheim. hinkelbein@akutmedizin.de
SO - Anaesthesist 2003 Jan;52(1):51-4.
DP - 2003 Apr
TI - Abstracts of the Society of Cardiovascular Anesthesiologists 25th Annual
Meeting and Workshops. Miami Beach, Florida, USA. April 26-30, 2003.
SO - Anesth Analg 2003 Apr;96(4 Suppl):1-144.
DP - 2002 Nov 23
TI - Questions over GA.
SO - Br Dent J 2002 Nov 23;193(10):547; author reply 547.
DP - 2003 Apr
TI - Anesthesia for magnetic resonance imaging in children: a survey of
Canadian pediatric centres.
SO - Can J Anaesth 2003 Apr;50(4):425.
DP - 2003 Apr
TI - Low-dose epidural anesthesia for cervical cerclage.
SO - Can J Anaesth 2003 Apr;50(4):424-5.
DP - 2003 Apr
TI - Spinal epidural hematoma and epidural analgesia.
SO - Can J Anaesth 2003 Apr;50(4):422-3.
DP - 2003 Apr
TI - Spinal anesthesia in an obese patient with osteogenesis imperfecta.
SO - Can J Anaesth 2003 Apr;50(4):421-2.
DP - 2003 Apr
TI - Effects of different anesthetic techniques on enzymatic activities in
ischemic femoral quadriceps.
SO - Can J Anaesth 2003 Apr;50(4):420-1.
DP - 2003 Apr
TI - Ventricular tachycardia during general anesthesia in a patient with
congenital long QT syndrome: [La tachycardie ventriculaire pendant
l'anesthesie generale chez une patiente atteinte du syndrome congenital du
QT long].
PG - 398-403
AB - PURPOSE: Congenital long QT syndrome is characterized by a corrected
QT
interval of at least 440 msec on the electrocardiogram and has been
associated with recurrent syncope, documented ventricular arrhythmia and
sudden death. There have been numerous articles over the past 20 years
describing isolated instances of surgical and anesthesia related
complications but the general anesthetic management of the condition
remains unclear. Clinical features: An 11-yr-old female with documented
long QT syndrome, with two episodes of syncope in the past, was admitted
for emergency drainage of left periorbital cellulitis. Anesthesia was
induced with propofol, fentanyl and rocuronium, and initially maintained
with nitrous oxide and halothane. After 20 min, the patient developed
ventricular tachycardia (torsade de pointes). Lidocaine 1 mg*kg(-1) iv was
given and the rhythm reverted to normal sinus. Halothane was discontinued
and the surgery proceeded without further incident. CONCLUSIONS: Our
review of the literature revealed that patients with long QT syndrome
whose symptoms are well controlled prior to surgery tend to do well
regardless of the anesthetic chosen. There are, however, theoretical
reasons to avoid anesthetics which either sensitize the myocardium to
catecholamines or which cause an increase in circulating levels of
catecholamines.
AD - Departments of Anesthesiology and Pediatrics, State University of New
York
at Stony Brook, Stony Brook, New York, USA.
SO - Can J Anaesth 2003 Apr;50(4):398-403.
DP - 2003 Apr
TI - Anesthesia for carpal tunnel release/L'anesthesie et la decompression
du
nerf median dans le canal carpien.
PG - 323-7
AD - Departments of Anesthesia and Surgery, Toronto Western Hospital, Toronto,
Ontario, Canada.
SO - Can J Anaesth 2003 Apr;50(4):323-7.
DP - 2003 Apr
TI - Patient safety in anesthesia - continuing challenges and opportunities/La
securite du patient en anesthesie - possibilites et defis permanents.
PG - 319-22
AD - Department of Anesthesia, University of Manitoba, Winnipeg, Manitoba,
Canada.
SO - Can J Anaesth 2003 Apr;50(4):319-22.
DP - 2002 Dec
TI - Thoracic epidurals in heart valve surgery: neurologic risk evaluation.
PG - 723-6
AB - OBJECTIVE: To evaluate the risk of neurologic complications resulting
from
epidural hematoma in a series of patients who had surgery for repair or
replacement of heart valves under combined general and thoracic epidural
anesthesia (TEA). DESIGN: Prospective observational study. SETTING:
General reference hospital associated with a university. PARTICIPANTS:
Patients (n = 305) who had surgery for replacement or repair of heart
valves. INTERVENTIONS: An epidural catheter was inserted at T1-3 as soon
as the patient was in the operating room, and local anesthetic was
administered as a bolus, then as a continuous infusion throughout the
operation and postoperatively. A protocol for postoperative neurologic
evaluation was used to rule out clinical signs of spinal lesions. A set of
safety guidelines was routinely followed. MEASUREMENTS AND MAIN RESULTS:
Preoperatively a battery of coagulation tests was systematically carried
out: activated partial thromboplastin time, platelet count, and
prothrombin time. Oral anticoagulants (warfarin) were stopped >60 hours
before surgery, and antiplatelet drugs (aspirin) were stopped 7 days
before. No patient required parenteral opiates postoperatively. Of the
patients, 65% were extubated in the operating room. There were no
neurologic complications resulting from epidural hematoma. CONCLUSION: TEA
can provide effective postoperative analgesia and assist in early tracheal
extubation in cardiac valve surgery. In this series, there were no
neurologic deficits detected. When certain safety measures are taken,
routine TEA is feasible and helpful in cardiac valve surgery.
CI - Copyright 2002, Elsevier Science (USA). All rights reserved.
AD - Department of Anesthesiology, Hospital General de Alicante, Alicante,
Spain. m.canto@telefonica.net
SO - J Cardiothorac Vasc Anesth 2002 Dec;16(6):723-6.
DP - 2003 Mar 29
TI - Moscow theatre siege and anaesthetic drugs.
SO - Lancet 2003 Mar 29;361(9363):1131.