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Biomedical subjects

C Bredahl

Publications and source records attributed to C Bredahl.

At least 19 recordsLinked to original sources
PubMed1998

[Acute pain service. Organization and results].

Postoperative pain therapy in modern clinical practice still has significant deficits. Establishing acute pain services is reported to be a method of improving pain therapy. In this prospective study, 104 orthopaedic patients were treated with a postoperative epidural infusion of a combination of bupivacaine and sufentanil. Pain intensity and side effects were recorded daily by pain management personnel, and the pain therapy was adjusted according to the patients' need. The results showed that pain control was insufficient in 29 patients, and that side effects developed in 45 patients, included one patient with late respiratory depression. We conclude that acute pain service is essential in order to improve postoperative analgesia.

Acute Disease↗
PubMed1998

[Treatment of pain via a cervical epidural catheter].

Cervical epidural anaesthesia (CEA) is a method suitable for regional anaesthesia of the upper extremity. CEA seems useful for postoperative pain relief after surgery in the shoulder region or both upper extremities, especially when the postoperative pain relief must be long lasting (days), and when it is desirable that the patient be able to actively move his affected joints during rehabilitation. Potential side effects of the method are respiratory- and haemodynamic changes. Thus, CEA is inappropriate for patients with severe respiratory disease, and in patients for whom extensive sympathetic block may prove disastrous (e.g. congestive heart failure, hypovolaemia).

Analgesia, Epidural↗
PubMed1996

Plasminogen activators and plasminogen activator inhibitor in portal blood from patients with and without gastric malignancy.

BACKGROUND: Plasminogen activators (PA) may be released by the gut and eliminated by the liver. Patients with liver disorders or malignancy often have abnormal plasma levels of PAs. Some tumours may produce PAs. METHODS: In patients undergoing gastric surgery for malignant (n = 18) or benign (n = 21) disorders., blood drawn from the portal vein and a peripheral vein was analysed for tissue-type plasminogen activator antigen and activity (tPA: Ag, tPA: Act), single-chain urokinase-type plasminogen activator activity (scuPA: Act), and plasminogen activator inhibitor antigen and activity (PAI: Ag, PAI: Act). RESULTS AND CONCLUSIONS: In both groups tPA: Act and scuPA: Act levels were significantly higher in portal blood than in peripheral blood, but tPA: Ag and PAI: Act levels did not differ. PAI: Act levels were significantly lower in patients with malignant disease, but levels of the other markers did not differ in the two groups.

Adult↗
PubMed1995

Effect of a radiant heater on post-operative hypothermia: comparison with a reflective blanket.

Thirty patients with post-operative hypothermia following major surgery (thoracic, abdominal, orthopaedic) were allocated randomly to either active warming with a radiant heater (500 W) or passive rewarming with a reflective blanket. Rectal temperature, mean skin temperature (at four measuring sites), continuous haemoglobin saturation and shivering were measured for 2 h post-operatively. Although post-operative heat supply with a radiant heater resulted in faster rewarming, there were no differences between the two groups with respect to haemoglobin saturation and shivering.

Abdomen↗
PubMed1994

[Midazolam and lorazepam as premedication. A randomized double-blind study].

Oral administration of midazolam and lorazepam as premedication was compared in a double-blind randomized clinical trial. Eighty patients scheduled for minor gynaecological surgery in general anaesthesia and 80 patients scheduled for hip arthroplasty in spinal anaesthesia were included. Assessments were: 1. patients subjective evaluation of the premedication, 2. sedation scale, 3. recovery of cognitive function assessed by Simple Paper-and-Pencil test and Postbox test, 4. amnesic effects. In the general anaesthesia group midazolam caused less postoperative sedation, less postoperative amnesia and cognitive function returned more rapidly. In the spinal anaesthesia group cognitive function returned more rapidly after midazolam. Midazolam should be preferred for premedication if rapid recovery is desired.

Administration, Oral↗
PubMed1994

Markers of coagulation and fibrinolysis in portal blood from patients with and without gastric malignancy.

BACKGROUND: The origin of coagulation and fibrinolysis abnormalities in cancer patients is unknown. The aim of this study was to measure markers of coagulation and fibrinolysis in portal and peripheral blood from patients with and without gastric malignancy. METHODS: Blood samples were drawn from the portal vein and a peripheral vein in 39 patients undergoing elective gastric surgery, 18 for gastric malignancy and 21 for benign disorders, and analyzed for prothrombin fragment 1 + 2 (F1 + 2), thrombin-anti-thrombin III complex (TAT), fibrinogen and fibrin degradation products (FgDP, FbDP), and fibrinopeptide A (FpA). RESULTS AND CONCLUSIONS: In portal blood, levels of F1 + 2, TAT, FpA, FgDP, and FbDP did not differ in the two groups. In peripheral blood, levels of FpA and FbDP were higher in cancer patients, but in a multiple regression model malignancy did not contribute significantly to variation in peripheral FpA or FbDP levels. In both groups FpA levels were higher in portal blood than in peripheral blood.

Antithrombin III↗
PubMed1994

Haemostatic activation before and after surgery in patients with and without gastric malignancy.

Pre- and postoperative plasma levels of Prothrombin Fragment 1 + 2 (F1 + 2), Thrombin-antithrombin III complex (TAT), Fibrinopeptide A (FpA), Fibrin and Fibrinogen Degradation Products (FbDP, FgDP) and Soluble Fibrin (SF) were measured in 40 patients undergoing gastric surgery in order to compare patients operated for benign (n = 21) and malignant (n = 19) disease. Plasma levels of F1 + 2, TAT, FbDP and SF on the first postoperative day were significantly higher than before operation. F1 + 2 and FbDP levels were further increased one week after surgery, at which time FgDP levels were also higher than preoperatively. A significant postoperative increase in FpA levels was found only in patients with malignant disease. When age was taken into consideration, significant differences between patients with and without malignancy were found only in the late postoperative period, as cancer patients had higher FpA and FbDP levels one week after surgery and higher FbDP levels one month after discharge from hospital.

Adult↗
PubMed1993

Continuous subcutaneous infusion of morphine--an alternative to extradural morphine for postoperative pain relief.

In a randomized, double-blind study of 40 patients undergoing total abdominal hysterectomy, we have compared continuous subcutaneous infusion (CSCI) of morphine with discontinuous extradural injection of morphine for postoperative analgesia at rest and during cough. The CSCI group received a bolus of morphine 0.1 mg kg-1 i.v. at the end of the operation and continued with s.c. infusion of morphine 30 micrograms kg-1 h-1. The extradural group received morphine 4 mg extradurally at 0, 2, 10 and 18 h after operation. Pain and side effects were evaluated at 2, 4, 8, 12 and 24 h after operation. In the extradural group, significantly smaller pain-scores were observed both at rest and during cough compared with the CSCI group. No significant difference was observed between the groups regarding supplementary doses of morphine, peak expiratory flow values or side effects. We conclude that morphine by CSCI is not as effective as morphine injected extradurally. However, CSCI seems to provide simple and relatively effective analgesia with a low rate of side effects.

Analgesia, Epidural↗
PubMed1993

Continuous blood gas monitoring in haemodialysis using an electrode inserted in the extracorporeal dialysis circulation.

The aim of this study was to evaluate the usefulness of continuous gas monitoring during haemodialysis using an oxygen- and carbon dioxide-sensitive electrode inserted in the 'arterial' line from the arteriovenous fistula. We investigated 15 patients with chronic renal failure, treated with regular bicarbonate haemodialysis. The PO2 and PCO2 were measured by the new method and compared to conventional blood gas analysis of the 'arterial' blood from the dialysis circulation. We found the in situ gas sensors were stable and there was no systematic difference between gas tensions measured by in situ and conventional blood gas measurements. The standard deviations of the difference between paired measurements for PO2 and PCO2 were 1.3 and 0.4 kPa, respectively. Therefore, the method can be used to detect major changes in blood gas tensions during haemodialysis.

Adult↗
PubMed1992

Mortality after hip fracture: results of operation within 12 h of admission.

This retrospective study was undertaken to evaluate the mortality and morbidity of patients undergoing hip fracture surgery within 12 h of admission, compared with surgery more than 12 h after admission, the patients had no acute medical conditions that required preoperative treatment. Mortality rates were based on survival of the patients up to 1 year after surgery. For patients with fractures of the femoral neck, and in whom surgery was performed within 12 hours of admission, the mortality rate was significantly lower from 5 months after the operation. Time of surgery did not influence the mortality of patients with trochanteric fractures. It is suggested that a fractured neck of the femur in an otherwise fit elderly patient should be regarded as a surgical emergency.

Adult↗
PubMed1992

Reflective blankets used for reduction of heat loss during regional anaesthesia.

We have studied the ability of reflective blankets to reduce net loss of body heat during regional anaesthesia for total hip arthroplasty. Thirty patients were allocated randomly to either the study group (insulated with reflective blankets) or the control group (no reflective blankets). Surgical and operation room draping, theatre temperature and i.v. fluid administration were standardized for all patients. Total body heat was deduced from core temperature (aural canal) and mean skin temperature (four measuring sites). After 2 h of surgery, loss of body heat was reduced significantly in patients wrapped in reflective blankets (26 kJ) compared with those in the control group (95 kJ).

Adult↗
PubMed1992

Prophylactic laryngo-tracheal aerosolized lidocaine against postoperative sore throat.

A randomized, double-blind study was carried out on 193 ASA I-II surgical patients to assess the effect of aerosolized lidocaine on sore throat, hoarseness and cough in connection with tracheal intubation. The study group received aerosolized lidocaine 100 mg 2 min before tracheal intubation, using a spray. The control group received no spray. The patients underwent a standardized general anaesthesia. The patients were interviewed when leaving the recovery room and the next day in the ward. Specific questions were asked regarding sore throat, cough and hoarseness. There were no significant differences between the two groups, which suggests that topical anaesthesia of the mucosa of the upper airway is ineffective as a means of ameliorating airway complaints in connection with tracheal intubation.

Administration, Inhalation↗
PubMed1991

[Continuous arteriovenous hemodialysis in acute renal insufficiency. Review of therapeutical results among 23 patients treated over a period of 2 years].

In critically ill patients with acute renal failure and unstable circulation, dialysis employing conventional haemodialysis may prove technically difficult. If, however, continuous arterio-venous haemofiltration is employed, the haemodynamic problems may be overwon but the method does not always provide effective control of azotaemia. Continuous arterio-venous haemodialysis (KAVHD) is a combination of ultrafiltration and dialysis. The efficacy of KAVHD was investigated retrospectively in 23 critically ill patients with acute renal failure and unstable circulation. All of the patients achieved acceptable steady state concentrations for serum creatinine and carbamide. Four out of five patients with hyperkalaemia obtained normal serum potassium after the first 24 hours of treatment with KAVHD. The average filtration volume was 6.1 1/24 hours, sufficient to provide parenteral nutrition and intravenous infusion and to maintain the negative fluid balance simultaneously. Fifteen patients (65%) died during the intensive course of treatment but none died from complications of KAVHD or renal failure. Renal function was reestablished in eight patients and seven of these could be discharged alive. KAVHD is an effective and simple method of treating critically ill patients with acute renal failure and unstable circulation.

Acute Kidney Injury↗
PubMed1991

[Anesthesia for single-day orthopedic surgery].

During the period 1 January 1989 to 31 December 1989, a total of 1,004 patients were submitted to outpatient single-day surgery in Aalborg Hospital. As fas as possible, the patients were anaesthetized with propofol (Diprivan)/alfentanil (Rapifen) and oxygen and atmospheric air. This form of anaesthesia was found to be rapid and suitable for single-day surgery. 8.1% of the patients required admission for further observation, 2.3% of these on account of anaesthesiological complications. It is concluded that, by means of meticulous planning, it is possible to carry out ambulant anaesthesia and surgery and, employing limited staff resources, it has proved possible to reduce the waiting time for outpatient intervention to 10-12 weeks.

Adolescent↗
PubMed1991

Changes in body heat during hip fracture surgery: a comparison of spinal analgesia and general anaesthesia.

Postoperative hypothermia initiates an increased oxygen demand in the postoperative period and may endanger patients with restricted cardiopulmonary reserves. In order to compare net heat losses and gains, we studied 28 women undergoing hip fracture surgery, using either general anaesthesia or spinal analgesia. The superficial and central temperatures were followed in the per- and postoperative period. Total body heat was calculated from temperature measurements. Temperature changes were unrelated to the type of anaesthesia. Large net heat losses occurred on transfer to the recovery room.

Aged↗
PubMed1990

[Seizures and opistotonus after propofol anesthesia. A possible connection].

A case of repeated tonic-chlonic seizures and opisthotonus which developed after anesthesia with propofol (Deprivan) in a woman aged 43 years is described. The seizures continued for seven days despite antiepileptic therapy. On the basis of this case and other case reports, it is recommended that propofol should only be employed with reservation in patients with known epilepsy or predisposition to epilepsy.

Adult↗
PubMed1989

[Otorhinolaryngologic diseases in general practice].

During a period of one year, the contact pattern during day working hours in general practice where diseases of the ear, nose and throat were concerned was registered as part of an investigation of disease pattern in the County of Arhus. Registration included the form of encounter, reason for encounter, diagnosis and possible referrals. It was demonstrated that 8.6% of all disease and symptom-induced encounters in general practice were concerned with ear, nose and throat disease. Complaints from the throat were the commonest. Coryza and tonsillitis comprised nearly half of all the diseases. The commonest diseases of the ear were acute otitis media and wax in the ear. Among upper respiratory diseases, acute infective conditions dominated. As compared with the usual age-distribution in general practice, coryza, tonsillitis, acute and secretory otitis media and chronic allergic rhinitis were considerably overrepresented in children. Examination in consulting room was the commonest form of encounter. The majority of the patients were considered by the general practitioners to be completely treated after one consultation.

Denmark↗