A national survey into perioperative anesthetic management of patients with a fractured neck of femur.

Background: We made a survey among Finnish anesthesiologists concerning the current perioperative anesthetic practice of hip fracture patients for further development in patient care.

Methods: All members of the Finnish Society of Anesthesiologists with a known e-mail address (786) were invited to participate in an internet-based survey.

Results: The overall response rate was 55% (423 responses); 298 respondents participated in the care of hip fracture patients.

The effect of body mass index on the spread of spinal block in patients with rheumatoid arthritis.

Purpose: Body mass index (BMI) has a significant effect on the spread of sensory spinal block in rheumatoid patients. We tried to achieve the same spread of spinal block for patients in three different BMI groups and, on the basis of the results from a preliminary study, used a simple method feasible for clinical practice. We hypothesized that BMI-related inverse dosing of plain bupivacaine according to low, normal, and high BMI would result in no difference in block extent.

The effect of desmopressin on blood loss in patients with rheumatoid arthritis undergoing hip arthroplasty.

Background: Blood loss is an important issue for patients with rheumatoid arthritis undergoing hip surgery. We hypothesised that intraoperative desmopressin treatment would result in a reduction in blood loss in rheumatoid patients undergoing total hip arthroplasty.

Methods: Seventy-five patients scheduled for elective total hip arthroplasty were randomised to three groups to receive 0.

Spread of spinal block in patients with rheumatoid arthritis.

Background: In clinical practice, we noticed a greater than expected spread of sensory spinal block in patients with rheumatoid arthritis. We decided to test this impression and compared the spread of standard spinal anaesthesia in rheumatoid and non-rheumatoid control patients.

Methods: Spinal anaesthesia with 3.

Reducing the risk of systemic embolization during gynecologic laparoscopy--effect of volume preload.

Background: About 27% of the population is known to have a patent foramen ovale. It can be opened if the left atrial pressure is less than the right atrial pressure. This pressure reversal has been reported during gynecologic laparoscopic surgery.

Reperfusion ventricular fibrillation and electric countershocks during coronary artery bypass operations--association with postoperative CK-MB release.

Reperfusion ventricular fibrillation during coronary artery bypass surgery is common and electric shocks are often needed to terminate it. Both the fibrillation and the reversing electric shocks are potentially detrimental to the myocardium. In 61 aortocoronary bypass patients with uncomplicated clinical course (no difficulties in weaning from bypass, no ECG changes and no inotropic medication), serial creatine kinase-MB values were recorded.

The effect of arterial pH on whole body oxygen uptake during hypothermic cardiopulmonary bypass in man.

To test the hypothesis of Rahn and Reeves that the optimal arterial pH during hypothermia follows the alpha-stat concept, we studied 50 patients during coronary artery bypass grafting or valve replacement (or both) and aortic occlusion. Intravenous anesthesia was produced by high-dose fentanyl. Thiopentone 3 mg.

Reversed left internal mammary artery graft for coronary bypass. Evaluation of function with digital subtraction angiography and radionuclide imaging.

Reversed left internal mammary artery grafting with retrograde flow to the left anterior descending coronary branch was used in five of 500 consecutive bypass operations. The indications were significant stenosis in the left subclavian artery (3 patients) or the proximal left internal mammary artery (1) and proximal damage to the left internal mammary artery during dissection from the thoracic wall (1). The postoperative clinical course was smooth in all five patients, with no evidence of myocardial ischemia.

The effect of thoracic epidural analgesia on respiratory function after cholecystectomy.

To assess the effect of thoracic epidural analgesia (TEA) on postoperative respiratory function and pulmonary complications, a prospective randomized trial was conducted in patients undergoing cholecystectomy. One hundred patients were allocated to TEA (n = 30), TEA + general anesthesia (TEA + GA) (n = 30), or general anaesthesia (GA) (n = 40) groups. Respiratory function was analysed by measuring forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), functional residual capacity (FRC), total lung capacity (TLC), peak expiratory flow (PEF) in the supine and sitting postures, and arterial blood gases.

The effect of thoracic epidural analgesia on postoperative stress and morbidity.

A hundred patients scheduled for cholecystectomy were randomized to either thoracic epidural anaesthesia and analgesia for 24 h with bupivacaine intraoperatively about 100 mg and 15 mg/h thereafter (TEA) for postoperative analgesia, TEA combined with general anaesthesia (low dose fentanyl) (TEA + GA) and general anaesthesia (GA) (low dose fentanyl). During TEA and TEA + GA the arterial pressure was significantly decreased as compared with GA. TEA was associated by an intense haemodilution in comparison with GA.

[Peridural anesthesia with bupivacaine-CO2 and bupivacaine-HCl. A comparative study].

Carbonated bupivacaine and bupivacaine hydrochloride were used for epidural anaesthesia in patients undergoing surgery of the lower extremities. Thirty patients received 20 ml 0.5% bupivacaine hydrochloride and 32 patients 20 ml 0.

Circulatory effects of pancuronium and alcuronium in patients with coronary artery stenosis.

Heart rate and systemic arterial blood pressure were recorded during induction of anaesthesia up to 9 min after endotracheal intubation in 92 patients scheduled for coronary artery bypass surgery, in order to study to what degree the circulatory response to induction of anaesthesia and intubation was modified by different relaxants. Pancuronium (pancuronium bromide) 0.1 mg X kg b.

Hydroxyethyl starches, dextran and balanced salt solution in correction of hypotension during epidural anaesthesia.

A low molecular weight (Mw 38 000) and a medium molecular weight (Mw 125 000) hydroxyethyl starch and a medium molecular weight dextran (Mw 70 000) solution were compared with a balanced salt solution in 123 patients undergoing operations of the lower extremities in epidural anaesthesia; 500 ml of the studied solutions were infused during 15 min after the injection of the epidural anaesthetic. The need for etilefrine hydrochloride as a vasoconstrictor in correcting hypotensive reactions was recorded. Changes in haemoglobin (Hb), haematocrit (Hct), serum total protein and serum albumin concentrations were measured.

Thoracic epidural analgesia and deep vein thrombosis in cholecystectomized patients.

The effect of continuous thoracic epidural analgesia (TEA) on the occurrence of postoperative deep vein thrombosis (DVT) was studied with the [125I]-fibrinogen uptake test in patients undergoing elective gallbladder surgery. The 98 patients were randomly allocated to three groups, viz. TEA for 24 hours, TEA plus general anesthesia with intermittent positive-pressure ventilation (IPPV) and general anaesthesia with IPPV but no TEA.