Abstract:
BACKGROUND:Epidural Analgesia (EA) may be used to provide pain relief after upper abdominal surgery. A variety of drugs and combinations may be used. Potential side effects lead some to believe EA should be restricted to high care areas. METHOD:The use of EA following upper abdominal surgery is surveyed in 214 hospitals in the United Kingdom by means of a postal questionnaire. RESULTS:Sixty-seven percent use EA frequently and 3% not at all. The low thoracic site is the most commonly used, by 65%. Forty-eight percent use a combination of sites. EA is most frequently achieved using a mixture of an opioid and a local anaesthetic (97%). No other agents are used. Fentanyl and diamorphine are the opioids used most widely (61% and 52% departments, respectively) in combination with local anaesthetic. Subcutaneous heparin is regularly used in 89% of departments. In 43%, the epidural is sited shortly after administering heparin. Use of EA is restricted solely to intensive or high-care units in 46% of hospitals. In 82% of departments, EA is continued for up to 72 h. Ninety-six percent of departments use continuous epidural infusions in the post-operative period. Adjunct analgesia includes non-steroidal anti-inflammatory drugs in 50% of departments. An anaesthetist supervises EA in 89% of hospitals. EA is considered to be the best mode of analgesia available by 80% of respondents. CONCLUSION:EA is widely used in the United Kingdom following upper abdominal surgery. A degree of consensus exists on the choice of drug types, their method of administration and duration. There is no consensus as to whether the technique should be used on a general ward, which opioid should be used or the timing of heparin.
journal_name
Acta Anaesthesiol Scandjournal_title
Acta anaesthesiologica Scandinavicaauthors
Cook TM,Eaton JM,Goodwin APdoi
10.1111/j.1399-6576.1997.tb04608.xsubject
Has Abstractpub_date
1997-01-01 00:00:00pages
18-24issue
1 Pt 1eissn
0001-5172issn
1399-6576journal_volume
41pub_type
杂志文章abstract::The Laryngeal Mask Airway (LMA) is a new type of oropharyngeal airway that provides an alternative to endotracheal intubation and standard mask anaesthesia in certain cases. Once the patient is adequately anaesthetised, it can be inserted blindly, without recourse to laryngoscopy or muscle relaxants. Anaesthetists of ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1990.tb03170.x
更新日期:1990-11-01 00:00:00
abstract:BACKGROUND:Inhalation of nitric oxide (INO) exerts both local and distant effects. INO in healthy pigs causes down-regulation of endogenous nitric oxide (NO) production and vasoconstriction in lung regions not reached by INO, especially in hypoxic regions, which augments hypoxic pulmonary vasoconstriction. In contrast,...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12030
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:In recent years it has become increasingly clear that a cross-talk between the inflammatory response and blood coagulation exists, although many of the underlying mechanisms remain unclear. In the present study we investigated the potential anti-inflammatory properties of two different anticoagulant compound...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2005.00633.x
更新日期:2005-04-01 00:00:00
abstract::The influence of an intravenous infusion of naloxone 1 microgram kg-1 h-1, in combination with intrathecal diamorphine, on analgesia and hormonal stress responses after laminectomy was assessed in a blinded, randomized, placebo-controlled study. Twenty-seven patients undergoing laminectomy with postoperative analgesia...
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.1399-6576.1992.tb03455.x
更新日期:1992-04-01 00:00:00
abstract:BACKGROUND:The clinical use of epidural analgesia has changed over past decades. Minimally invasive surgery and emergence of alternative analgesic techniques have led to an overall decline in its use. In addition, there is increasing awareness of the patient-specific risks for complications such as spinal haematoma and...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.13219
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Cardiac arrest remains the leading cause of death in Western societies. Advanced Life Support guidelines propose epinephrine (adrenaline) for its treatment. The aim of this study was to assess whether a calcium sensitizer agent, such as levosimendan, administered in combination with epinephrine during cardio...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2007.01383.x
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Many former intensive care unit (ICU) patients report difficulties in cognitive functions especially in their daily life. We aimed to measure perceived cognitive impairments in daily life in survivors of critical illness and their family member controls (FMC). METHODS:Perceived cognitive impairments were as...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12755
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Laparoscopic hysterectomy (LH) is expected to provide fast and comfortable recovery, plus an early return to normal daily activities. This study was carried out to compare the outcome after LH in patients anesthetized with isoflurane or propofol. METHODS:Sixty-two patients undergoing LH were randomized to r...
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.1399-6576.1997.tb04699.x
更新日期:1997-03-01 00:00:00
abstract::Epidural abscess is a rare but serious complication of epidural anesthesia for peri- and postoperative analgesia. It is feared because of possible persistent neurological deficits. Epidural abscess presents mostly with a classic triad of symptoms: back pain, fever and variable neurological signs and symptoms. When neu...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.2002.460523.x
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND:Although anesthetics have some cardioprotective properties, these benefits are often counterbalanced by their negative inotropic effects. Xenon, on the other hand, does not influence myocardial contractility. Thus, xenon may be a superior treatment for the maintenance of global hemodynamics, especially durin...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2009.02116.x
更新日期:2010-04-01 00:00:00
abstract::Anesthesia and recovery during the first hour after propofol and methohexital anesthesia for termination of pregnancy, lasting about 12 min, were compared, the latter in a double-blind manner by means of psychomotor tests (coin counting and continuous auditory reaction time). Muscle movements and hiccups were seen sig...
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.tb03072.x
更新日期:1990-04-01 00:00:00
abstract:BACKGROUND:Major hindfoot and ankle surgery is associated with severe postoperative pain, which is effectively alleviated by combined sciatic and saphenous nerve blockade. Local anaesthetics with added dexamethasone consistently prolongs the duration of pain relief compared to local anaesthetics alone. However, whether...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章,随机对照试验
doi:10.1111/aas.13054
更新日期:2018-04-01 00:00:00
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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.1399-6576.1986.tb02462.x
更新日期:1986-10-01 00:00:00
abstract:BACKGROUND:The value of shock-index has been demonstrated in hospital triage, but few studies have evaluated its prehospital use. The aim of our study was to evaluate the association between shock-index in prehospital critical care and short-term mortality. METHODS:We analyzed data from the national helicopter emergen...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.13765
更新日期:2020-12-19 00:00:00
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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.1399-6576.1986.tb02360.x
更新日期:1986-01-01 00:00:00
abstract: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. The present paper describes with help of transesophageal echocardiography...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:The mortality of patients suffering from acute decompensated liver disease treated in the intensive care unit (ICU) varies between 50% and 100%. Previously published data suggest that liver-specific score systems are less accurate compared with the ICU-specific scoring systems acute physiology and chronic he...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2012.02692.x
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Medical emergency team (MET) activation criteria serve as a predictor of serious adverse events on hospital wards and in the emergency department (ED). We aimed to determine whether in-hospital MET activation criteria would be useful in identifying patients at risk in pre-hospital care. METHODS:The data wer...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12499
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:In locations where oxygen and anesthesia gas supplies are limited, and where circle systems are not practical, means to reduce fresh gas flow during maintenance of inhalational anesthesia are of potential value. We investigated whether a common transport breathing apparatus could be modified to allow interch...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.2005.00848.x
更新日期:2006-01-01 00:00:00
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journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.2002.460714.x
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Sevoflurane, a potent inhalational anaesthetic agent that is structurally similar to halothane, has some favourable characteristics, but may also be able to trigger malignant hyperthermia (MH) in susceptible patients. The diagnosis of malignant hyperthermia susceptibility relies on the in vitro contracture t...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.2000.440320.x
更新日期:2000-03-01 00:00:00
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journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1994.tb03890.x
更新日期:1994-04-01 00:00:00
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journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1034/j.1399-6576.2000.441015.x
更新日期:2000-11-01 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::Colloid osmotic pressure (COP) of some of the most frequently used plasma replacement fluids was measured with a colloid osmometer. COP of 4% human albumin solutions was only half that of normal human serum (13.6 +/- 0.6 vs. 27.5 +/- 2.7 mmHg (1.8 +/- 0.1 vs. 3.7 +/- 0.4 kPa)) (mean +/- s.d.), whereas COP of 20% human...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1993.tb03741.x
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:The aim of the study was to investigate the correlation between EEG indicators and clinical scores based on the RLS85 (Reaction Level Scale 85) in comatose patients. The results of a simple visual assessment of the EEG, using an arbitrary scale with typical EEG patterns, were compared with those obtained by ...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1996.tb04540.x
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:Ketamine (K) has been reported to produce bronchodilation in patients suffering from asthma. Although most researchers have used indirect measurements to study the effect of K in vivo, the reliability of these indirect methods are controversial. We have developed a new technique to measure the bronchial cros...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1998.tb05106.x
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Genetic variability contributes to variable clinical response to opioids. This study emerged from the observation of three Norwegian patients who showed no or extraordinary poor response to very high doses of opioids. We suspected a genetic defect and applied a 'most likely candidate gene' approach to invest...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/aas.12739
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:Stroke volume variation (SVV)--as measured by the pulse contour cardiac output (PiCCO) system--predicts the cardiac output response to a fluid challenge in patients on controlled ventilation. Whether this applies to patients on pressure support ventilation is unknown. METHODS:Thirty consecutive patients wit...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 临床试验,杂志文章
doi:10.1111/j.1399-6576.2006.01120.x
更新日期:2006-10-01 00:00:00
abstract:BACKGROUND:Lidocaine has been shown to have direct vasoconstrictive effects at low concentrations. Since lidocaine inhibits endothelium-dependent vasodilation in vitro, the vasoconstrictor effect of lidocaine may be due to inhibition of endothelium-derived relaxing factor(EDRF/NO). Therefore, the current study was desi...
journal_title:Acta anaesthesiologica Scandinavica
pub_type: 杂志文章
doi:10.1111/j.1399-6576.1997.tb04781.x
更新日期:1997-06-01 00:00:00