Neurobiological insight into hyperbaric hyperoxia.
Abstract: Hyperbaric hyperoxia (HBO) is known to modulate aerobic metabolism, vasoreactivity and blood flow in the brain. Nevertheless, mechanisms underlying its therapeutic effects, especially in traumatic brain injury (TBI) and stroke patients, are debated. The...Clinical Trial – Tourniquet and Quadricepsforce
The purpose for this study is to investigate the quadriceps (thigh) function preoperatively
and 48 hours postoperatively during knee arthroplasty (total replacement of the knee joint)
in a randomised study with or without the use of a Tourniquet (cuff around the thigh during
surgery) (100 mm Hg > systolic blood pressure).
Clinical Trial – Safety of Spinal Anesthesia in Patients With Tibial Shaft Fracture
There is a elevated risk of acute compartment syndrome (ACS) related to tibial shaft
fractures due to oedema and reduced blood flow in traumatised tissues. This may lead to lack
of oxygen and even necrosis. Symptoms of ACS are severe pain, hypoaesthesia, pain during
flexion of the ankle and swollen leg in clinical examination. Paralysis and lack of distal
pulses are late symptoms of ACS.
Many experts think that effective relief of pain caused by regional anaesthesia (RA) may hide
the symptoms of the ACS. This may be incorrect. The evidence of dangers related to RA is
based on old patient-series and single case-reports. Some of these studies report the
symptoms of ACS (hypaesthesia and even pain) being caused by RA. Majority of the conclusions
in these studies cannot be confirmed by an expert of RA. It is also possible that there are
more hemodynamic changes related to general anaesthesia (GA) which may predispose to ACS.
There are no modern, randomized and controlled studies of the safety of RA in patients with
tibial shaft fracture.