Abstract：
BACKGROUND:Deteriorated organ function and reduced stress response in very old patients may cause post-operative morbidity and mortality. We wanted to identify immediate and longer-term outcome after anaesthesia and surgery in the oldest of the old patients. METHODS:We analysed retrospectively anaesthesia and hospital records of patients who were over 100 years old when undergoing major emergency surgery in our hospital during 1990-2004. RESULTS:Altogether, 12 patients (median age 101 years) underwent 14 operations (nine for hip fracture, four for lower extremity circulatory problems and one for peritonitis). During anaesthesia, invasive arterial pressure was monitored in eight patients while central venous pressure (CVP) was monitored in only one patient. Spinal anaesthesia with bupivacaine was given as a continuous technique in six and as single-shot spinal anaesthesia in five cases. Both spinal (11) and general (3) anaesthesias were characterized by marked drops in arterial pressure. Haemodynamics was managed with intravenous (i.v.) fluids and vasopressors. Five patients had post-operative delirium. Mortality at 30 days, 6 months and 1 year was 25%, 42% and 50%, respectively. Within 15 days of the operation, three patients had died (pneumonia, cerebral infarction and myocardial infarction). Nine patients returned home and six of them lived in their pre-operative mental and physical state for at least a year. CONCLUSION:Independently of the anaesthetic method, marked drops in blood pressure occurred, requiring pharmacological intervention. We assume that in most of the patients, hypovolaemia explains the intra-operative haemodynamic instability. A 25%, 30-day mortality may be regarded as acceptable and, overall, these very old patients tolerated emergency surgery quite well.
journal_name
Acta Anaesthesiol Scandjournal_title
Acta anaesthesiologica Scandinavicaauthors
Konttinen N,Rosenberg PHdoi
10.1111/j.1399-6576.2006.00953.xsubject
Has Abstractpub_date
2006-03-01 00:00:00pages
283-9issue
3eissn
0001-5172issn
1399-6576pii
AAS953journal_volume
50pub_type
杂志文章abstract：:The aim of this study was to identify risk factors associated with postoperative pulmonary complications. The influence of the anaesthetic technique was evaluated (i.e. general contra regional anaesthesia and long contra intermediately acting muscle relaxants (pancuronium and atracurium)) taking into account the patie...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1111/j.1399-6576.1992.tb03570.x
更新日期：1992-11-01 00:00:00
abstract：:Plasma vasopressin levels were measured during open-heart surgery in nine children. The control value of vasopressin was 5.5 +/- 1.5 (s.e.mean) microU/ml. During extracorporeal circulation, a maximum 7.3-fold increase of plasma vasopressin level was demonstrated. This high level of vasopressin was considered to have c...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1111/j.1399-6576.1984.tb02071.x
更新日期：1984-06-01 00:00:00
abstract：:Reports of midazolam interaction with vecuronium in animals prompted us to compare midazolam (0.25 mg kg-1) with thiopentone (5 mg kg-1) for possible interactions with vecuronium in patients, when used for induction of anaesthesia. After the administration of either of the two induction agents, the patients received v...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1111/j.1399-6576.1989.tb02908.x
更新日期：1989-05-01 00:00:00
abstract：BACKGROUND:Hysterectomy is often carried out as same-day surgery. Treatment of postoperative pain is, therefore, of utmost importance to ensure timely discharge from hospital. Methadone has several desirable pharmacological features, including a long elimination half-life. Theoretically, a single intraoperative dose co...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章,随机对照试验
doi：10.1111/aas.13433
更新日期：2019-10-01 00:00:00
abstract：:This study examines the effects of nitrous oxide on haemodynamics, anterior left ventricular (LV) function and incidence of myocardial ischaemia in abdominal vascular surgical patients with coronary artery disease. Forty-seven patients were randomly assigned to isoflurane-fentanyl anaesthesia with nitrous oxide-oxygen...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1111/j.1399-6576.1994.tb04007.x
更新日期：1994-11-01 00:00:00
abstract：:During laparoscopic hepatic resection, an abrupt decrease in FE'CO(2) (from 28 mmHg to 9 mmHg) associated with near cardiac arrest occurred concomitantly with hepatic vein laceration and the use of an argon beam coagulator system. During venous gas embolism, transesophageal echocardiography (TEE) proved the transpulmo...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1111/j.1399-6576.2007.01361.x
更新日期：2007-08-01 00:00:00
abstract：BACKGROUND:Incident reporting and fieldwork in operating rooms have shown that some of the errors that arise in anaesthesia relate to inadequate use of non-technical skills. To provide a tool for training and feedback on nurse anaesthetists' non-technical skills, this study aimed to adapt the Anaesthetists' Non-Technic...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1111/aas.12315
更新日期：2014-08-01 00:00:00
abstract：BACKGROUND:Hydroxyethyl starches (HES) have been shown to decrease clot strength and to increase coagulation times assessed by thromboelastography (TEG). HES with minimal anticoagulant side-effects is beneficial for plasma volume expansion in the perioperative setting. A comparison of the in vivo effects of high, middl...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1034/j.1399-6576.2003.470112.x
更新日期：2003-01-01 00:00:00
abstract：BACKGROUND:A growing proportion of the population is using opioids for longer time periods, but little is known about the characteristics of patients who are persistent opioid users. We therefore studied the association between socio-economic factors and persistent vs. short-term opioid use 4 years later. METHODS:The ...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1111/aas.12281
更新日期：2014-04-01 00:00:00
abstract：BACKGROUND:Neostigmine, used for reversal of neuromuscular block, has been implicated in the development of postoperative nausea and vomiting (PONV). The use of mivacurium, which does not require neostigmine reversal due to its metabolism by plasma cholinesterase, has made it possible to study the effect of neostigmine...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1034/j.1399-6576.2001.045004495.x
更新日期：2001-04-01 00:00:00
abstract：:The effects of the non-depolarizing muscle relaxants pancuronium (Pancuronium) and vecuronium (Norcuron) (0.1 mg/kg) on myocardial blood flow, myocardial oxygen consumption, myocardial lactate balance, cardiovascular dynamics and electrocardiogram were studied in two groups of eight patients undergoing coronary artery...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1111/j.1399-6576.1990.tb03096.x
更新日期：1990-07-01 00:00:00
abstract：:The haemodynamic effects of morphine (2.5 mg kg-1) and fentanyl (16.7 and 25 micrograms kg-1) were compared in patients undergoing coronary artery bypass surgery. Morphine or fentanyl in combination with pancuronium, nitrous oxide and a small dose of thiopentone produced some deterioration of myocardial performance. B...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1111/j.1399-6576.1983.tb01919.x
更新日期：1983-04-01 00:00:00
abstract：BACKGROUND:If intravenous access cannot be accomplished during cardiopulmonary resuscitation in children, tracheal administration of 100 micrograms/kg of adrenaline (ten times greater than the intravenous dose) is recommended. METHODS:In a randomized crossover study we recoreded the hemodynamic effect of a low dose of...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1111/j.1399-6576.1996.tb04562.x
更新日期：1996-09-01 00:00:00
abstract：BACKGROUND:Various methods are used to reduce venous blood pressure in the hepato-splanchnic circulation, and hence minimise blood loss during liver surgery. Previous studies show that combination of vasopressin and nitroglycerin reduces portal pressure and flow in patients with portal hypertension, and in this study w...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1111/aas.13117
更新日期：2018-08-01 00:00:00
abstract：BACKGROUND:As evidence exist that severe neurological damage or prolonged death after inappropriate CPR could occur, restraints and indications for CPR were perceived as necessary. The objective of this review is to examine policies and attitudes towards end-of-life decisions in Europe and North America and to outline ...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章,评审
doi：10.1111/j.1399-6576.2006.01150.x
更新日期：2006-11-01 00:00:00
abstract：BACKGROUND:The mechanism behind indomethacin-induced cerebral vasoconstriction is incompletely understood. We tested the hypothesis that the mixed endothelin-1 receptor antagonist bosentan would modify or prevent indomethacin-induced reduction of CBF in the anaesthetized pig. Furthermore, we investigated the effect of ...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1034/j.1399-6576.2003.00019.x
更新日期：2003-02-01 00:00:00
abstract：BACKGROUND:B-lines as typical artefacts of lung ultrasound are considered as surrogate measurement for extravascular lung water. However, B-lines develop in the sub-pleural space and do not allow assessment of the whole lung. Here, we present data from the first observational multi-centre study focusing on the correlat...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章,评审
doi：10.1111/aas.13586
更新日期：2020-08-01 00:00:00
abstract：BACKGROUND:Pain is a sensory and emotional experience that is influenced by physiologic, sensory, affective, cognitive, socio-cultural, and behavioral factors. Consistent with the perspective to improve the postoperative pain control, the present study has the purpose of assessing the effect of presurgical clinical fac...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1034/j.1399-6576.2002.461015.x
更新日期：2002-11-01 00:00:00
abstract：:The psychological reactions to hospitalization, anaesthesia, and operation in a group of 107 children from 1 to 12 years old, anaesthetized with ketamine or halothane after randomization were investigated through questionnaires, which the parents answered 1 month postoperatively. The percentage of replies was 96.3%. F...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1111/j.1399-6576.1977.tb01258.x
更新日期：1977-01-01 00:00:00
abstract：BACKGROUND:Critically ill patients at southern latitudes have been shown to have low vitamin D levels that were associated with prolonged hospital stay. To our knowledge no studies have been conducted on vitamin D status amongst critically ill patients at high northern latitudes. Despite the Icelandic population tradit...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1111/aas.12748
更新日期：2016-10-01 00:00:00
abstract：:Premedication for cardiac surgical patients attempts to achieve relief of anxiety with minimal or no cardiorespiratory changes. Nalbuphine (NUBAIN) and morphine produced similar decreases in respiratory rate (1-3 breaths per min) and PaO2 (averaging 1.34 kPa), and increases in arterial PaCO2 (averaging 0.56 kPa). Card...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1111/j.1399-6576.1984.tb02066.x
更新日期：1984-06-01 00:00:00
abstract：:Trauma resuscitation is a complex situation, and most organisations have multi-professional trauma teams. Non-technical skills are challenged during trauma resuscitation, and they play an important role in the prevention of critical incidents. Simulation-based training of these is recommended. Our research question wa...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章,评审
doi：10.1111/aas.12336
更新日期：2014-08-01 00:00:00
abstract：:Blood loss has previously been shown to be more detrimental for spontaneously hypertensive (SHR) than for normotensive Wistar-Kyoto (WKY) rats. To evaluate whether this decreased tolerance to blood loss is due to disturbances in circulatory control or to alterations in cellular function caused by the hypertensive dise...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1111/j.1399-6576.1986.tb02431.x
更新日期：1986-07-01 00:00:00
abstract：:Differential lung ventilation to achieve optimised ventilation for each lung is a procedure rarely used in the intensive care unit, to treat select cases of severe unilateral lung disease in intensive care. However, existing techniques both for securing the airway and ventilating the lungs are challenging and have com...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1111/aas.12285
更新日期：2014-04-01 00:00:00
abstract：BACKGROUND:In a rat closed head trauma model we examined both the time course of lipid peroxidation and the effects of halothane, isoflurane, and sevoflurane on it by analysis of malondialdehyde (MDA) formation. METHODS:Animals were divided randomly into five groups: sham-operated (SO), n=18; control-closed head traum...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1111/j.1399-6576.2008.01635.x
更新日期：2008-05-01 00:00:00
abstract：BACKGROUND:In patients with unstable necks, the neck should be stabilized during induction of anaesthesia, but this may make tracheal intubation difficult. Awake intubation may produce straining, which could be detrimental to the unstable neck. METHODS:We studied 20 patients with unstable necks to examine the efficacy...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 临床试验,杂志文章
doi：10.1034/j.1399-6576.2001.045007818.x
更新日期：2001-08-01 00:00:00
abstract：:Ketamine sometimes produces posthypnotic emergency reactions, such as prolonged hallucination or delirium. In a previous paper, we showed that physostigmine, an anticholinesterase agent, counteracts the manifestation of effects of ketamine at some doses. In the present study, we investigated the mechanism of the antag...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1111/j.1399-6576.1992.tb03497.x
更新日期：1992-07-01 00:00:00
abstract：BACKGROUND:Pituitary-adrenal secretion during induced hypotension for middle-ear surgery has received little attention. Previous work failed to differentiate the effects of induced hypotension from surgical stimulation. We have undertaken a preliminary study examining the effects of hypotension, achieved with labetalol...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1111/j.1399-6576.1998.tb05075.x
更新日期：1998-01-01 00:00:00
abstract：BACKGROUND:It has been proposed that the analysis of positive end-expiratory pressure (PEEP)-induced volume changes can quantify alveolar recruitment. The potential of a lung to be recruited is expected to be high in acute respiratory distress syndrome (ARDS), where collapsed lung tissue is very common. The volume chan...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1111/aas.12432
更新日期：2015-01-01 00:00:00
abstract：:The haemodynamic adaptation early after aorto-coronary bypass surgery, with special reference to the influence of body temperature on postoperative vasoconstriction, was studied in 20 patients. Cardioplegia arrest was used in all cases. Eleven patients were cooled to 30 degrees C during cardiopulmonary bypass, and nin...
journal_title：Acta anaesthesiologica Scandinavica
pub_type： 杂志文章
doi：10.1111/j.1399-6576.1979.tb01485.x
更新日期：1979-12-01 00:00:00
