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Biomedical subjects

A Bendtsen

Publications and source records attributed to A Bendtsen.

14 recordsLinked to original sources
PubMed1999

Cardiovascular and respiratory changes and convalescence in laparoscopic colonic surgery: comparison between carbon dioxide pneumoperitoneum and gasless laparoscopy.

HYPOTHESIS: Gasless laparoscopy produces smaller cardiopulmonary and systemic changes than carbon dioxide (CO2) laparoscopy during colonic surgery. DESIGN: Prospective randomized trial. SETTING: Department of Surgery in a university hospital. PATIENTS: Twenty-two patients scheduled for laparoscopic colonic resection; 5 patients were excluded because of conversion to open surgery (N = 17). INTERVENTIONS: Patients were randomized to either gasless (n = 9) or conventional CO2 (n = 8) surgery. MAIN OUTCOME MEASURES: Intraoperative assessment of hemodynamic factors and pulmonary function, and postoperative assessment of pain, pulmonary function, convalescence, and various injury factors were done several times until 30 days after surgery. Surgical complications were noted. RESULTS: Descending aorta blood flow after 30 minutes (P=.03) and heart rate after 150 minutes were higher in the CO2 group (P=.009). Central venous pressure, PaCO2 inspiration pressure, and end tidal CO2 level were significantly higher in the CO2 group (P = .05, .03, .04, and .01, respectively). Patients in the CO2 group had less pain during mobilization and coughing (P = .008 and .006, respectively), and were significantly more fatigued (P = .04). No other important differences were observed in intraoperative hemodynamic factors, postoperative convalescence, immunocompetence, or pulmonary function. CONCLUSION: No clinically important differences in cardiovascular and systemic response were observed between patients undergoing CO2 or gasless laparoscopy for colonic disease.

Aged↗
PubMed1999

Changes in plasma potassium concentration during carbon dioxide pneumoperitoneum.

Hyperkalaemia with ECG changes had been noted during prolonged carbon dioxide pneumoperitoneum in pigs. We have compared plasma potassium concentrations during surgery in 11 patients allocated randomly to undergo either laparoscopic or open appendectomy and in another 17 patients allocated randomly to either carbon dioxide pneumoperitoneum or abdominal wall lifting for laparoscopic colectomy. Despite an increasing metabolic acidosis, prolonged carbon dioxide pneumoperitoneum resulted in only a slight increase in plasma potassium concentrations, which was both statistically and clinically insignificant. Thus hyperkalaemia is unlikely to develop in patients with normal renal function undergoing carbon dioxide pneumoperitoneum for laparoscopic surgery.

Adolescent↗
PubMed1998

Patients' desire for information about anaesthesia: Danish attitudes.

BACKGROUND: Patients' desire for information about anaesthesia has been examined in a number of Commonwealth countries but not in Scandinavia. A questionnaire was distributed to form a basis for giving Danish patients more appropriate preoperative information. METHODS: 201 preoperative patients in Denmark were asked to complete a questionnaire. The patients were divided into subgroups according to: age, gender, residential origin, ASA group, educational level, type of anaesthesia planned and number of previous anaesthetics. RESULTS: Patients from a city area required significantly more information than patients from a rural/urban area about premedication drugs, drips/catheters, pain/pain relief and complications. Men more than women preferred to know about dangerous complications. Information about pain/pain relief, duration of anaesthesia, and influence of anaesthesia on daily activities such as eating, drinking, mobilisation was given the highest priority, while unpleasant information such as about complications and needles was given the lowest priority. Meeting the anaesthetist and information about alternative methods of anaesthesia and premedication drugs were given only moderate priority. Ranking information in Denmark was significantly correlated with Scotland, Canada and Australia, despite profound differences in priority. More often than Danish patients, Australian patients felt they had right to know, and especially about complications. CONCLUSION: Patients from a city area required more information than patients from a rural/urban area. Information about the influence on daily activities was preferred to unpleasant information. Ranking information in Denmark was correlated with a number of Commonwealth countries.

Activities of Daily Living↗
PubMed1985

Use of a continuous infusion of althesin in neuroanaesthesia. Changes in cerebral blood flow, cerebral metabolism, the EEG and plasma alphaxalone concentration.

Ten patients with small supratentorial tumours were studied during craniotomy. Cerebral blood flow (CBF) was measured in the contralateral hemisphere by a modification of the Kety and Schmidt technique using xenon-133 i.v. With an Althesin infusion rate of 0.2 ml kg-1 h-1, CBF was 24.4 +/- 5.4 ml min-1/100 g and CMRO2 1.87 +/- 0.44 ml min-1/100 g at PaCO2 4.1 +/- 0.7 kPa (mean +/- SD). During constant infusion rates of Althesin, steady values of CMRO2 were obtained, while an increase in infusion rate of 150% was associated with an increase in plasma alphaxalone concentration, a decrease in CMRO2 and a tendency of further EEG suppression. However, great inter- and intraindividual variations were present, and correlations between CMRO2, EEG activity and plasma alphaxalone concentration were weak.

Adult↗
PubMed1985

Methylprednisolone half-life during simultaneous barbiturate treatment and mechanical hyperventilation of neurosurgical patients.

The pharmacokinetics of methylprednisolone sodium succinate (MP) were studied in six neurosurgical patients under intensive treatment with large doses of MP, barbiturates, and mechanical hyperventilation. The study showed a remarkable level of enzyme induction within 24 hours after starting treatment, when the first blood samples were taken. The half-life (t 1/2) for MP during barbiturate and hyperventilation therapy was found to be reduced by a mean 55% (p less than 0.01) in relation to the t 1/2 of MP when administered alone. Studies on the day after termination of barbiturate intake indicated a tendency for an increase in the t 1/2 of MP, but it was not significantly different from the pretermination assessment (p greater than 0.05). On the basis of this study it is not possible to determine if the change in t 1/2 alone is governed by enzyme induction or by a combination of this plus a change in the distribution and clearance of the steroid. The clinical implication of these findings is that patients who are undergoing steroid treatment and at the same time are sedated with barbiturates should have their MP dose increased in order to compensate for the marked reduction of t 1/2 of MP.

Adolescent↗
PubMed1984

Minimum cerebral blood flow and metabolism during craniotomy. Effect of thiopental loading.

Cerebral blood flow and metabolism were measured repeatedly during surgery for cerebral tumours by a modification of the classical Kety & Schmidt method using 133Xe infusion intravenously. Our standard procedure for neuroanaesthesia (pentobarbitone-fentanyl induction, halothane-nitrous oxide maintenance) reduced blood flow from 47.1 to 24.2 ml X 100 g X ml-1 and metabolism from 3.30 to 1.83 ml O2 X 100 g-1 X ml-1. PaCO2 was reduced by hyperventilation from 5.3 to 3.6 kPa. Additional thiopental loading and maintenance using 4 + 4 mg X kg-1 (n = 5) or 8 + 8 mg X kg-1 (n = 5) reduced cerebral metabolism by an additional 15% (P less than 0.01) and blood flow by 16.5% (P less than 0.01), while mean arterial blood pressure fell from 11.0 to 9.9 kPa (P less than 0.05). PaCO2 remained unchanged. This additional reduction in cerebral metabolism and blood flow is small, but we nevertheless conclude that it may well be of clinical interest to the problem of protecting the brain in case of episodes of focal cerebral ischaemia which may arise peroperatively during intracranial surgery.

Adult↗