Horner's syndrome after long-term epidural block.
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Adult↗
Biomedical subjects
L S Rasmussen
Publications and source records attributed to L S Rasmussen.
[Lumbar regional analgesia in patients during antithrombotic treatment. Procedures used at the Danish anesthesiologic departments illustrated by a questionnaire study].
The attitudes of Danish anaesthetists to employment of lumbar epidural analgesia (EA) or spinal analgesia (SA) in patients receiving perioperative antithrombotic therapy was assessed by a questionnaire investigation. EA and SA were absolute or relative contraindications in patients receiving low-dose heparin therapy in 38% and 24% of the departments. The same figures for patients receiving dextran or acetylsalicylic acid therapy were 3-8%. The limiting value for the P-coagulation factors II, VII and X for employing EA and SA varied considerably in the departments questioned. EA and SA were, however, contraindicated in patients receiving regular anticoagulation in the majority of departments. On a national basis, only two confirmed cases of symptom-producing haemorrhage in the spinal canal which could be attributed to thrombosis prophylaxis after SA/EA have been recognized. Both of these developed after regular anticoagulation therapy. The authors do not find any basis for warning against use of EA/SA in patients receiving subcutaneous heparin therapy, dextran or acetyl salicylic acid, unless another predisposition to haemorrhage is present.
Aged↗
Antithrombotic efficacy of continuous extradural analgesia after knee replacement.
We have studied the effect of extradural analgesia on postoperative venous thrombosis in patients undergoing knee arthroplasty. Forty-eight patients were allocated randomly to receive either general anaesthesia or extradural analgesia with local anaesthetics for 3 days. All patients wore compressive elastic stockings and no anticoagulant drugs were administered. Bilateral venography was performed 10 days after surgery. Continuous extradural analgesia did not impede mobilization of the patients. One case of nonfatal pulmonary embolism occurred in a patient who received general anaesthesia. The use of continuous extradural analgesia resulted in a significant difference in the total incidence of deep vein thrombosis (18% compared with 59% after general anaesthesia (P = 0.02]. The incidence of calf vein thrombosis was 12% compared with 45% after general anaesthesia (P = 0.05).
Adult↗
Lumbar regional anaesthesia and prophylactic anticoagulant therapy. Is the combination safe?
A survey has been carried out in all Danish anaesthetic departments (n = 80) regarding the attitude towards the use of epidural/spinal lumbar analgesia in patients who were receiving prophylactic anticoagulant therapy for the prevention of thromboembolism. About 60% of the departments used the techniques in patients receiving low-dose heparin and no side effects had been experienced. Spinal and epidural anaesthesia were in general regarded as being contraindicated in patients fully anticoagulated with vitamin K antagonists. In the world literature, the attitude towards the combination is conflicting. No randomised trial has been performed and complications are almost entirely confined to patients fully anticoagulated with vitamin K antagonists. Only one case of an epidural haematoma has been recorded when subcutaneous low-dose heparin was used as thromboprophylaxis.
Aged↗
Awakening and recovery of simple cognitive and psychomotor functions 2 h after anaesthesia for day-case surgery--total intravenous anaesthesia with propofol-alfentanil versus thiopentone-alfentanil.
Fifty-seven patients undergoing minor out-patient gynaecological procedures were allocated to one of two total intravenous anaesthesia regimes: propofol and alfentanil or thiopentone and alfentanil. Diazepam was given orally as premedication. To assess objectively the quality of recovery, the patients underwent a number of tests pre-operatively and two hours post-operatively. The time to opening of eyes and orientation was equal in both groups, as was the recovery of the tested cognitive and psychomotor functions after 2 h, when the score in both groups had returned to baseline. We conclude that the use of propofol instead of thiopentone for shorter surgical procedures gives no advantage as regards length of stay in hospital.
Adolescent↗
Lower thrombosis risk with epidural blockade in knee arthroplasty.
Thirty-six patients scheduled for knee arthroplasty were randomized to general or epidural anesthesia that was prolonged into the postoperative period. All the patients wore graded compression stockings until full ambulation. No other thrombo-prophylactic treatment was given. In diagnosing deep venous thrombosis, bilateral ascending venography was performed 9-11 days after surgery. The incidence of thrombosis was 2/13 in the epidural group versus 10/16 in the general anesthesia group (P less than 0.05).
Adult↗