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E Sloth

Publications and source records attributed to E Sloth.

22 records · Page 2Linked to original sources

Spinal anaesthesia with plain 0.5% bupivacaine at 19 degrees C and 37 degrees C.

Forty-five men aged 50-80 yr undergoing urological surgery under spinal anaesthesia were allocated randomly to three groups. All patients received 0.5% plain bupivacaine 3 ml injected at the L2-3 interspace. The temperature of the solution in group 1 was 19 degrees C, in groups 2 and 3 37 degrees C. In groups 1 and 2 the injection was performed with the patient sitting; in group 3 the patient was in a lateral horizontal position. Spread of block, intensity of motor block and cardiovascular stability were measured. Warming the solution from 19 degrees C to 37 degrees C before spinal injection with the patient in the sitting position did not significantly affect these variables. However, the extent of analgesia was reduced significantly when the 37 degrees C solution was injected with the patient in the lateral horizontal compared with the sitting position.

Aged↗

Relationship between anesthetic procedure and contact of anesthesia personnel with patient body fluids.

We recorded the frequency with which anesthesia personnel came in contact with patient body fluids in order to provide an empirical basis for the recommendation of relevant precautions. Anesthesia personnel completed a questionnaire when performing a range of standardized procedures. The rate of contact with blood was as follows: catheterization of peripheral vein, 18%; insertion of central venous catheter, 87%; arterial puncture, 38%; lumbar puncture, 23%; catheterization of the extradural space, 34%; tracheal intubation, 4%; tracheal extubation, 9%; suction of oral cavity, pharynx, or trachea, 13%; intramuscular injection of drug, 8%; and establishment or discontinuation of drip for blood transfusion, 43%. By using protective gloves, 98% of contacts with patient blood would have been prevented. Blood contact was more frequent in the emergency ward than in the operating room (P less than 0.05). Health care workers were not able to predict when a specific procedure would imply that contact with patient blood would occur. We recommend that specific precautions be adopted for the various procedures and discuss precautions that could have prevented contact with body fluid.

Anesthesiology↗

Multiplane transesophageal Doppler echocardiographic measurements of the velocity profile in the human pulmonary artery.

Eight healthy, unsedated volunteers were studied to introduce a new non-invasive method for detailed blood velocity measurements and to evaluate flow patterns in the human pulmonary artery during end-expiratory apnea. With a multiplane transesophageal ultrasonic probe, spectral Doppler velocity registration was performed in nine different spatial locations across the vessel area. The pulmonary trunk could be visualized in all patients. The mean temporal velocity profile was virtually flat despite an instantaneous skewness that rotated counterclockwise up to 180 degrees. Furthermore, our data indicate that a good estimate of the temporal and spatial mean velocity can be obtained from velocity recordings based on centrally placed sample volumes. This makes the future application of Doppler-based measurement of cardiac output in the pulmonary artery hopeful. The ability of multiplane transesophageal echocardiography to estimate the area of the elastic human pulmonary artery, however, has to be evaluated more extensively before the clinical importance of this tool for measurement of cardiac output can be established.

Adult↗

Pediatric multiplane transesophageal echocardiography in congenital heart disease: new possibilities with a miniaturized probe.

In recent years, transducers for multiplane Doppler echocardiography have demonstrated their superior imaging performance in adult patients. To date, the size of these probes has limited their use in pediatric patients. In this article, we report our initial experience with a recently developed miniaturized transducer with all conventional imaging and Doppler modalities. The study focused primarily on imaging performance by comparing standard biplane images with those obtained in oblique planes. The investigations were carried out intraoperatively or during interventional catheterization in patients with congenital heart disease. We observed no complications in a study population of 15 children (weight range of 5 to 63 kg and an age range of 96 days to 11 years). The probe was easy to handle and provided excellent images. Additional information was obtained in several cases and documentation of clinical findings was easier because an optimal image plane almost always could be displayed. We concluded that pediatric multiplane Doppler echocardiography has considerably improved investigative performance compared with the conventional monoplane or biplane studies normally available for this age group. In neonates, however, investigation with the multiplane technique is limited by the size of the patient.

Child↗