Acta Anaesthesiologica Scandinavica

Melanio Bruceta, Luisa De Souza, Zyad J Carr, Anthony Bonavia, Allen R Kunselman, Kunal Karamchandani
BACKGROUND: Admission to the intensive care unit (ICU) after surgery can be associated with significant morbidity and mortality. This observational cohort study aims to identify perioperative factors associated with postoperative ICU admission in patients undergoing elective non-cardiac surgery. METHODS: Data from the ACS NSQIP® database at a tertiary care academic medical center was analyzed from January 2011 to September 2016. Univariable and multivariable logistic regression of patient and surgery-specific characteristics was performed to assess association with postoperative ICU admission...
November 11, 2019: Acta Anaesthesiologica Scandinavica
Anna Clebone, Barbara K Burian, Avery Tung
BACKGROUND: Critical events require that clinicians process information and make decisions quickly. To reduce mental workload during such events, cognitive aids have been developed. We have previously observed that designing such aids to facilitate discrete information transfer decreased time to information finding. However, whether clinicians perceive aids designed for discrete information transfer as more usable than step-by-step designs is unclear. We hypothesized that experimental cognitive aids designed for discrete information transfer would be judged more usable than step-by-step Linear aids...
November 10, 2019: Acta Anaesthesiologica Scandinavica
Marija Barbateskovic, Sara R Krauss, Marie O Collet, Nina C Andersen-Ranberg, Ole Mathiesen, Janus C Jakobsen, Anders Perner, Jørn Wetterslev
BACKGROUND: Haloperidol is the most frequently used drug to treat delirium in the critically ill patients. Yet, no systematic review has focussed on the effects of haloperidol in critically ill patients with delirium. METHODS: We conducted a systematic review with meta-analysis and Trial Sequential Analysis of randomised clinical trials (RCTs) assessing the effects of haloperidol versus any intervention on all-cause mortality, serious adverse reactions/events, days alive without delirium, health-related quality of life (HRQoL), cognitive function and delirium severity in critically ill patients with delirium...
October 29, 2019: Acta Anaesthesiologica Scandinavica
Matias Vested, Mona Tarpgaard, Kirsten Eriksen, Lars S Rasmussen
BACKGROUND: The aim of this quality assurance study was to determine the proportion of patients with residual block (train-of-four (TOF) ratio < 0.9) upon conclusion of surgery after a bolus of cisatracurium 0.1 mg/kg. It was considered good quality if less than 10% of the study population had residual block upon conclusion of surgery. METHODS: A total of 40 patients ≤ 3 years of age scheduled for cleft lip and palate repair were consecutively enrolled. They received general anaesthesia with either sevoflurane and fentanyl (n=20) or propofol and remifentanil (n=20)...
October 25, 2019: Acta Anaesthesiologica Scandinavica
Johan Kristiansson, Eva Hagberg, Bengt Nellgård
BACKGROUND: The effect of time-to-surgery on mortality in acute hip fracture (AHF) patients has been debated and studies are inconsistent regarding from what time-limit mortality starts to increase. At Sahlgrenska University Hospital/Mölndal, surgery is recommended within 24 hours leaving little time for preoperative optimisation. However, internationally the definition of early surgery varies between 24 to 48 hours and over. This retrospective study was initiated to investigate the relation between time-to-surgery and 30-day mortality...
October 25, 2019: Acta Anaesthesiologica Scandinavica
Kristina K Hansen, Hanne I Jensen, Torben S Andersen, Christian F Christiansen
BACKGROUND: Asynchrony is a common problem in patients treated with noninvasive ventilation (NIV). Neurally adjusted ventilatory assist (NAVA) has shown to improve patient-ventilator interaction. However, it is unknown whether NIV-NAVA improves outcomes compared to noninvasive pressure support (NIV-PS). METHODS: This observational cohort study included patients 18 years or older receiving noninvasive ventilation using an oro-nasal face mask for more than 2 hours in a Danish ICU...
October 25, 2019: Acta Anaesthesiologica Scandinavica
Talora Steen, Philipp B Lirk, Martin I Sigurdsson
BACKGROUND: Patients who have limb amputation are at risk of chronic pain, including phantom limb pain, that can be challenging to treat. The aim of this study was to describe the incidence of preoperative opioid usage and the incidence and risk factors for new persistent postoperative opioid usage in opioid-naïve patients after limb amputation. METHODS: A retrospective cohort study including all patients 18 years and older undergoing upper or lower extremity amputations in Landspitali University Hospital between 2005 - 2015...
October 24, 2019: Acta Anaesthesiologica Scandinavica
Niels D Nielsen, Merete N Madsen, Helle K Østergaard, Siska Bjørn, Erik M Pedersen, Thomas D Nielsen, Kjeld Søballe, Jens Børglum, Thomas F Bendtsen
BACKGROUND: A femoral nerve block relieves pain after total hip arthroplasty, but its use is controversial due to motor paralysis accompanied by an increased risk of fall. Assumedly, the iliopsoas plane block targets the hip articular branches of the femoral nerve without motor blockade. However, this has only been indicated by a cadaver study. Therefore, we designed the present volunteer study. METHODS: Twenty healthy volunteers were randomly allocated to blinded paired active vs...
October 24, 2019: Acta Anaesthesiologica Scandinavica
Oscar Haude, Lucilla E Overdijk, Paul J M van Kesteren, Bart F Geerts, Bart M P Rademaker
BACKGROUND: During hysteroscopic surgery intravasation of irrigation fluid occurs, leading to potentially dangerous intravascular fluid overload. Currently, intravasation is usually measured volumetrically as fluid deficit. Intravasation could also be calculated using the decrease in haemoglobin or increase in chloride ion concentration, both phenomena known to result from intravasation. We compared the values of intravasation measured volumetrically as fluid deficit versus calculated from the biochemical change in haemoglobin and chloride...
October 24, 2019: Acta Anaesthesiologica Scandinavica
Kasper H Thybo, Daniel Hägi-Pedersen, Jørn Wetterslev, Jørgen B Dahl, Janus C Jakobsen, Niels Anker Pedersen, Karina Jakobsen, Hans Henrik Bülow, Louise Ibsen, Søren Overgaard, Ole Mathiesen
BACKGROUND: The 'Paracetamol and Ibuprofen in Combination' (PANSAID) trial showed that combining paracetamol and ibuprofen resulted in lower opioid consumption than each drug alone and we did not findan increase in risk of harm when using ibuprofen versus paracetamol. The aim of this subgroup analysis was to investigate differences in benefits and harms of the interventions in different subgroups. We hypothesized the intervention effects would differ in subgroups with different risk of pain or adverse events...
October 24, 2019: Acta Anaesthesiologica Scandinavica
Elin Eb Bjornestad, Michael F Haney
Managing an emergency caesarean section patient (C - section) is a challenging aspect of obstetric anaesthesia practice. The urgency of delivery can influence the mode of anaesthesia due to short time limits from decision to delivery. Given widely recognized risks associated with general anaesthesia and urgent/emergent C-section, how often can one safely manage the parturient with regional anaesthesia? Is this an expected result of subspecialty training, to more aggressively use regional anaesthesia in this setting? While spinal anaesthesia has gained wide acceptance, even with limited time frame goals from decision to delivery, epidural anaesthesia should be used when labour analgesia has been established prior to an emergency C-Section...
October 19, 2019: Acta Anaesthesiologica Scandinavica
Erlend Skraastad, Petter Christian Borchgrevink, Tom Ivar Lund Nilsen, Johan Raeder
BACKGROUND: Postoperative pain, side-effects and time to mobilisation are indicators for the quality of postoperative recovery. The aim of this randomised controlled study was to investigate if Efficacy Safety Score (ESS) combined with a wireless patient monitoring system would improve these clinical outcomes for patients at a general surgical ward. METHODS: The trial included 195 patients randomised to a standard care group (SC-Group) or intervention group (INT-Group) receiving continuous wireless monitoring of vital signs combined with ESS the first 24 postoperative hours...
October 13, 2019: Acta Anaesthesiologica Scandinavica
Claus B Christiansen, Mikkel H Madsen, Christian Rothe, Asger M Andreasen, Lars H Lundstrøm, Kai H W Lange
BACKGROUND: Sciatic nerve blocks are used for many orthopaedic procedures on the knee, lower leg, foot and ankle. However, as nerve block durations vary considerably, the timing of supplemental analgesia is challenging. Therefore, knowledge on the effect of local anaesthetic (LA) dose on block duration is important to outweigh the benefits of increasing LA dose against the risk of LA systemic toxicity. In this randomized, double-blind trial, we aimed to explore the relationship between the volume of ropivacaine 0...
October 12, 2019: Acta Anaesthesiologica Scandinavica
C Skjold, A M Møller, K Wildgaard
BACKGROUND: Preoperative pain management of hip fracture patients is complex. Femoral nerve block (FNB) is used for hip fractures to reduce pain and demand for systematic analgesia. The objective of the study was to systematically investigate the efficacy of single-shot FNB for hip fracture patients. METHODS: Five databases were searched from inception until 8th of May 2019. We included randomized controlled trials (RCT's) assessing pain relief in patients with hip fractures...
October 9, 2019: Acta Anaesthesiologica Scandinavica
Eve Sfeir Machado, Gleicy Keli-Barcelos, Elise Dupuis-Lozeron, Martin R Tramèr, Christoph Czarnetzki
BACKGROUND: TOF-Cuff® is a modified blood pressure cuff used to monitor neuromuscular block. We compared the assessment of spontaneous neuromuscular recovery between TOF-Cuff® (test device) and TOF Watch SX® (reference device). METHODS: Forty patients aged 18-65 years undergoing elective surgery were enrolled. TOF-Cuff® was installed on an upper arm and the TOF Watch SX® on the thumb of the opposite side. Anaesthesia was induced and maintained with intravenous propofol and sufentanil...
October 8, 2019: Acta Anaesthesiologica Scandinavica
Margaret Ekstein, Lilach Zac, Reut Schvartz, Or Goren, Carolyn F Weiniger, Ari DeRowe, Gad Fishman
BACKGROUND: Obstructive sleep apnea (OSA) occurs in 1%-4% of children; adenotonsillectomy is an effective treatment. Mortality/severe brain injury occurs among 0.6/10 000 adenotonsillectomies; in children, 60% are secondary to airway/respiratory events. Earlier studies identified that children aged <2 years, extremes of weight, with co-morbidities of craniofacial, neuromuscular, cardiac/respiratory disease, or severe OSA are at high risk for adverse post-operative respiratory events (AE)...
October 6, 2019: Acta Anaesthesiologica Scandinavica
Magni Gudmundsson, Per Persson, Gaetano Perchiazzi, Stefan Lundin, Christian Rylander
BACKGROUND: Transpulmonary driving pressure plays an important role in today's understanding of ventilator induced lung injury. We have previously validated a novel non-invasive method based on stepwise increments of PEEP to assess transpulmonary driving pressure in anaesthetised patients with healthy lungs. The aim of this study was to validate the method in patients who were mechanically ventilated for different diagnoses requiring intensive care. METHODS: We measured transpulmonary pressure (Ptp) and calculated transpulmonary driving pressure (ΔPtp) in 31 patients undergoing mechanical ventilation in an intensive care unit...
October 4, 2019: Acta Anaesthesiologica Scandinavica
Martin Fredholm, Kirsten Jörgensen, Erik Houltz, Sven-Erik Ricksten
BACKGROUND: The aim of the present study was to compare the effects of milrinone and levosimendan on right ventricular (RV) inotropy and lusitropy in patients after aortic valve replacement (AVR) for aortic stenosis, a procedure in which an abnormal postoperative RV function may be seen. METHODS: In a prospective, blinded trial, 31 patients were randomized to receive either milrinone (0.4 and 0.8 µg/kg/min, n = 16) or levosimendan (0.1 and 0.2 µg/kg/min, n = 15) after AVR for aortic stenosis...
September 25, 2019: Acta Anaesthesiologica Scandinavica
Sajeev Mahendran, John Nguyen, Ethan Butler, Anders Aneman
Background Venoarterial carbon dioxide pressure (pv-a CO2 ) and content (Cv-a CO2 ) differences, including the ratio to arteriovenous oxygen content difference (Ca-v O2 ), and free energy changes (-∆∆Ga-v ) may reflect tissue hypoperfusion. The associations with changes in cardiac output (CO) or oxygen consumption (VO2 ) following fluid bolus administration were investigated. Methods Single-centre, observational study of 89 adult post-operative cardiac surgical patients admitted to ICU. The pv-a CO2 , Cv-a CO2 and their ratios to Ca-v O2 as well as the -∆∆Ga-v were determined before and after a 250-500 mL fluid bolus using arterial, central venous and mixed venous blood gas analyses...
September 23, 2019: Acta Anaesthesiologica Scandinavica
Gunnar Malmqvist, Micael Appelblad
No abstract text is available yet for this article.
September 23, 2019: Acta Anaesthesiologica Scandinavica
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