Topical pharyngeal anesthesia with articaine for gastroscopy: a double-blinded, randomized cross-over study in healthy volunteers.

Objectives: The benefits of topical pharyngeal anesthesia for gastroscopy remain under debate. Articaine, a local anesthetic with fast onset and offset of action as well as low systemic toxicity, could be a promising choice for topical anesthesia. The objective of this study was to assess whether topical pharyngeal anesthesia with articaine is beneficial in sedated gastroscopy.

Promoting emotional and behavioral interventions in ASD treatment: Evidence from EPIGRAM, A naturalistic, prospective and longitudinal study.

Background: Prognostic factors from naturalistic treatment studies of children with Autism Spectrum Disorder (ASD) remain largely unknown. We aimed to identify baseline and treatment-related prognostic predictors at 1-year follow-up after Integrative Care Practices (ICPs).

Methods: Eighty-nine preschool children with severe ASD were given ICP combining nine therapeutic workshops based on children's needs.

Goal-directed fluid management associates with fewer postoperative fluid collections in pancreatoduodenectomy patients.

Background: The association between perioperative fluid management and complications in pancreatoduodenectomy patients remains controversial. We explored the association between fluid management and radiological signs of complications.

Methods: We examined pancreatoduodenectomy patients operated between July 2014 and December 2015 (n = 125) and between January 2017 and June 2018 (n = 124).

Optimal Perioperative Fluid Therapy Associates with Fewer Complications After Pancreaticoduodenectomy.

Background: Optimal fluid management in pancreaticoduodenectomy patients remains contested. We aimed to examine the association between perioperative fluid administration and postoperative complications.

Methods: We studied 168 pancreaticoduodenectomy patients operated in 2015 (n = 93) or 2017 (n = 75) at Helsinki University Hospital.

Randomized comparison of the feasibility of three anesthetic techniques for day-case open inguinal hernia repair.

Study Objective: Comparison of local anesthetic infiltration (LAI), spinal anesthesia (SPIN) and total intravenous anesthesia (TIVA) for open inguinal herniorrhaphy. We hypothesized that patients receiving LAI could be discharged faster than SPIN and TIVA patients.

Design: Randomized, prospective trial.

Perioperative Paravertebral Regional Anaesthesia and Breast Cancer Recurrence.

Aim: Retrospective and basic science data suggest that perioperative regional anaesthesia (PRA) may reduce tumour recurrence after cancer surgery. This retrospective archive study tested the anti-metastatic effect of PRA.

Patients And Methods: We screened the database of the Helsinki University Hospital for patients with breast cancer who had either perioperative paravertebral block (PVB) or sham block (SHAM) in 2000-2003.

Alopecia induced by tumour necrosis factor-alpha antagonists: description of 52 cases and disproportionality analysis in a nationwide pharmacovigilance database.

Objectives: The aim of this research was to describe the cases of TNF-α antagonist-related alopecia reported in the French Pharmacovigilance Database (FPVD) and to investigate the association between exposure to TNF-α antagonists and occurrence of alopecia.

Methods: All spontaneous reports of TNF-α antagonist-related alopecia recorded in the FPVD between January 2000 and April 2012 were colligated and described. We conducted disproportionality analyses (case/non-case method) to assess the link between the occurrence of alopecia and exposure to TNF-α antagonists.

Hyperbaric articaine with or without fentanyl in spinal anaesthesia: patient and observer blinded comparison.

Background: The rapid and short-acting local anaesthetic articaine is a feasible spinal anaesthetic for day-case open inguinal herniorrhaphy (OIH). We hypothesised that similarly to other spinal local anaesthetics, the addition of fentanyl may prolong articaine spinal analgesia without prolonging motor block.

Methods: We performed a randomised, controlled study in 100 adult patients undergoing OIH.

Randomised comparison of hyperbaric articaine and hyperbaric low-dose bupivacaine along with fentanyl in spinal anaesthesia for day-case inguinal herniorrhaphy.

Background And Objective: Low-dose mixture of hyperbaric bupivacaine and fentanyl is commonly used in day-case spinal anaesthesia. Using hyperbaric articaine, the onset may be faster and duration more predictable than with bupivacaine-fentanyl. We compared these two spinal anaesthetics for inguinal herniorrhaphy.

Pharmacokinetics of ropivacaine in patients with chronic renal failure.

Background: As ropivacaine and its metabolites are excreted by the kidneys, we studied their disposition in subjects with renal dysfunction.

Methods: Twenty patients with moderate or severe renal insufficiency and 10 healthy volunteers received ropivacaine 1 mg kg(-1) i.v.

Shaping the future of Scandinavian anaesthesiology: a position paper by the SSAI.

Traditionally, Scandinavian anaesthesiologists have had a very broad scope of practice, involving intensive care, pain and emergency medicine. European changes in the different medical fields and the constant reorganising of health care may alter this. Therefore, the Board of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) decided to produce a Position Paper on the future of the speciality in Scandinavia.

Fixed digital contractures revealing light-chain amyloidosis.

Among the many clinical manifestations of light-chain (AL) amyloidosis, musculoskeletal involvement is rarely reported. We describe the case of a 72-year-old woman who was referred to our rheumatology department for fixed flexion contractures of the fingers that developed concomitantly with a decline in general health. Macroglossia and recent-onset dyspnea were noted.

Fixed digital contractures revealing light-chain amyloidosis.

Among the many clinical manifestations of light-chain (AL) amyloidosis, musculoskeletal involvement is rarely reported. We describe the case of a 72-year-old woman who was referred to our rheumatology department for fixed flexion contractures of the fingers that developed concomitantly with a decline in general health. Macroglossia and recent-onset dyspnea were noted.

Comparison of hyperbaric and plain articaine in spinal anaesthesia for open inguinal hernia repair.

Background: Fast onset and short duration are prominent properties of the amide-type local anaesthetic articaine. Similar to bupivacaine, a hyperbaric solution of articaine may produce faster onset and shorter duration of spinal anaesthesia than a plain solution.

Methods: Patients undergoing open inguinal hernia repair received in random order articaine 84 mg in either hyperbaric (HyperA, n=49) or plain solution (PlainA, n=48) intrathecally.

Epidural analgesia diminished pain but did not otherwise improve enhanced recovery after laparoscopic sigmoidectomy: a prospective randomized study.

Background: The primary hypothesis for this study was that epidural analgesia reduces the use of opioids and thus advances bowel function and oral intake and shortens hospital stay after laparoscopic sigmoidectomy performed according to principles of enhanced recovery after surgery.

Methods: For this study, 60 patients with complicated diverticular disease were randomized to the epidural anesthesia group or the control group before surgery. Postoperative oxycodone consumption, pain, and recovery parameters were followed for 14 days.

Effect of paracetamol and coxib with or without dexamethasone after laparoscopic cholecystectomy.

Background: Pain after laparoscopic cholecystectomy (LCC) is multifactorial. Effective post-operative pain control is necessary in LCC performed as day-case surgery. We studied the efficacy of paracetamol or valdecoxib with or without dexamethasone after LCC.

Laparoscopic cholecystectomy with carbon dioxide pneumoperitoneum is safe even for high-risk patients.

Background: Because of absorbed carbon dioxide (CO(2)) and elevated intraabdominal pressure (IAP), CO(2) pneumoperitoneum (CO(2)PP) has potentially harmful intraoperative circulatory and ventilatory effects. Although not clinically significant for healthy patients, these effects are assumed to be deleterious for patients with a high risk for anesthesia (American Society of Anesthesiology [ASA] 3 and 4) and significant cardiopulmonary, renal, or hepatic diseases. The authors assessed CO(2)PP-related adverse effects by comparing ASA 3 and 4 patients who underwent laparoscopic cholecystectomy (LC) with or without CO(2)PP.

Alveolar echinococcosis of the spine.

Alveolar echinococcosis (AE) is a rare parasitic disease caused by the larval stage of Echinococcus multilocularis. It differs from cystic echinococcosis caused by Echinococcus granulosus. The main endemic areas of AE are Alaska, Canada, Japan, and parts of Europe.

Preincisional paravertebral block reduces the prevalence of chronic pain after breast surgery.

We reported earlier that preincisional paravertebral block (PVB) provides significant immediate postoperative analgesia after breast cancer surgery. In the same patients (n = 60), a 1-yr follow-up was performed to find out whether PVB could also reduce the prevalence of postoperative chronic pain. The follow-up consisted of a 14-day symptom diary and telephone interviews 1, 6, and 12 mo after surgery.

Comparison of airway management with the intubating laryngeal mask, laryngeal tube and CobraPLA by paramedical students in anaesthetized patients.

Background: Because of the importance of airway management in emergency care, alternative methods with shorter learning curves for inexperienced personnel have been looked for as a substitute for endotracheal intubation (ETI).

Methods: We compared the success of insertion, oxygenation and ventilation of the intubating laryngeal mask (ILMA), laryngeal tube (LT) and CobraPLA (COB) in anaesthetized patients when used by paramedical students. After informed consent, 96 patients were monitored and anaesthetized for general surgery without the use of a muscle relaxant.

Drug-related visits to a district hospital emergency room.

The role of adverse drug reactions (ADRs) as a cause of hospital visits varies depending on the type of hospitals. Our aim was to determine the incidence of drug-related emergency department visits to a district hospital, and to identify the drugs and patient groups involved. All patient visits to the emergency department of a Finnish district hospital were evaluated prospectively for 6 months.