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Evidence in perioperative care is insufficient. There is an urgent need for large perioperative research programmes, including pragmatic randomised trials, testing daily clinical treatments and unanswered question, thereby providing solid evidence for effects of interventions given to a large and growing number of patients undergoing surgery and anaesthesia. This may be achieved through large collaborations. Collaboration for Evidence‐based Practice and Research in Anaesthesia (CEPRA) is a novel collaborative research network founded to pursue evidence‐based answers to major clinical questions in perioperative medicine. The aims of CEPRA are to (1) improve clinical treatment and outcomes and optimise the use of resources for patients undergoing anaesthesia and perioperative care, and (2) disseminate results and inform caretakers, patients and relatives, and policymakers of evidence‐based treatments in anaesthesia and perioperative medicine. CEPRA is inclusive in its concept. We aim to extend our collaboration with all relevant clinical collaborators and patient associations and representatives. Although initiated in Denmark, CEPRA seeks to develop an international network infrastructure, for example, with other Nordic countries. The work of CEPRA will follow the highest methodological standards. The organisation aims to structure and optimise any element of the research collaboration to reduce economic costs and harness benefits from well‐functioning research infrastructure. This includes successive continuation of trials, harmonisation of outcomes, and alignment of data management systems. This paper presents the initiation and visions of the CEPRA network. CEPRA aims to be inclusive, patient‐focused, methodologically sound, and to optimise all aspects of research logistics. This will translate into faster research conduct, reliable results, and accelerated clinical implementation of results, thereby benefiting millions of patients whilst being cost and labour‐saving. [ABSTRACT FROM AUTHOR]

Background: Postextubation dysphagia (PED) is a common complication to endotracheal intubation in critically ill patients and may lead to pneumonia, prolonged ventilation, longer hospital stays, and increased mortality. Recognizing dysphagia is paramount to preventing adverse events. The aim of this study was to describe PED management by investigating practice in Danish intensive care units (ICUs) focusing on current practice in 2023 (screening, prevention, and treatment), perceived best practice (barriers and facilitators), and when possible, to compare practice in 2017 and 2023., Methods: Self-reported, cross-sectional survey of dysphagia practice in Danish ICUs administered from April to May 2023. In addition, data were compared with the 2017 Dysphagia in Intensive Care Evaluation study, when possible., Results: Only half of Danish ICUs reported to have a PED protocol, and less than half routinely screen patients for dysphagia after extubation. Most common screening methods were the oral mechanism examination, water test, and Facio-oral tract therapy. Nurses and physicians often relied on an overall physical assessment of the patient. Best treatment methods were uniformly agreed to be patient positioning, modification of food and fluids, use of ergonomic utensils, and compensatory maneuvers. Key barriers to dysphagia management were lack of specialized staff, under-recognition of dysphagia as a health issue, and lack of standardized protocols., Conclusion: Awareness of PED is increasing and identification, prevention, and treatment is slowly improving, but systematic implementation of protocols for dysphagia screening and treatment could enhance dysphagia management in Danish ICUs., (© 2024 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.)

Background: Persistent opioid use following surgery is common especially in patients with preoperative opioid use. This study aims to determine the long‐term effect of an individualised opioid tapering plan versus standard of care in patients with a preoperative opioid use undergoing spine surgery at Aarhus University Hospital, Denmark. Methods: This is the 1‐year follow‐up of a prospective, single‐centre, randomised trial of 110 patients who underwent elective spine surgery for degenerative disease. The intervention was an individualised tapering plan at discharge and telephone counselling 1 week after discharge, compared to standard of care. Postoperative outcomes after 1 year include opioid use, reasons for opioid use and pain intensity. Results: The overall response rate to the 1‐year follow‐up questionnaire was 94% (intervention group 52/55 patients and control group 51/55 patients). Forty‐two patients (proportion = 0.81, 95% CI 0.67–0.89) in the intervention group compared to 31 (0.61, 95% CI 0.47–0.73; p =.026) patients in the control group succeeded in tapering to zero 1 year after discharge (p =.026). One patient (0.02, 95% CI 0.01–0.13) in the intervention group compared to seven patients (0.14, 95% CI 0.07–0.26) in the control group were unable to taper to their preoperative dose 1 year after discharge (p =.025). Back/neck and radicular pain intensity was similar between study groups. Conclusion: These results suggest that an individualised tapering plan at discharge combined with telephone counselling 1 week after discharge can reduce opioid use 1 year after spine surgery. [ABSTRACT FROM AUTHOR]

A new pain questionnaire should be simple, be documented to have discriminative function, and be related to previously used questionnaires. We were not able to find Danish words that were reliably back-translated to the English words ‘splitting’ or ‘gnawing’. A simple three-word set of evaluative terms had good separation when rated on a VAS scale (‘let’ 17.5 ± 6.5 mm; ‘moderat’ 42.7 ± 8.6 mm; and ‘stærk’ 74.9 ± 9.7 mm). The questionnaire was able to discriminate among the six painful conditions with 77% accuracy by just using the descriptive words. The accuracy of the questionnaire increased to 96% with the addition of evaluative terms (for pain at rest and with activity), chronicity (acute vs. chronic), and location of the pain. A Danish pain questionnaire that subjects and patients can self-administer has been developed and validated relative to the words used in the English McGill Pain questionnaire. The discriminative ability of the questionnaire among some common painful conditions has been tested and documented. The questionnaire may be of use in patient care and research. [ABSTRACT FROM AUTHOR]

After an extensive survey of the medical literature we present compelling evidence that the first intensive care unit was established at Kommunehospitalet in Copenhagen in December 1953. The pioneer was the Danish anaesthetist Bjørn Ibsen. The many factors that interacted favourably in Copenhagen to promote the idea of intensive care therapy, half a century ago, are also described. [ABSTRACT FROM AUTHOR]

Background: Most data on intensive care unit (ICU) patients with COVID‐19 originate in selected populations from stressed healthcare systems with shorter term follow‐up. We present characteristics, interventions and longer term outcomes of the entire, unselected cohort of all ICU patients with COVID‐19 in Denmark where the ICU capacity was not exceeded. Methods: We identified all patients with SARS‐CoV‐2 admitted to any Danish ICU from 10 March to 19 May 2020 and registered demographics, chronic comorbidities, use of organ support, length of stay, and vital status from patient files. Risk factors for death were analyzed using adjusted Cox regression analysis. Results: There were 323 ICU patients with confirmed COVID‐19. Median age was 68 years, 74% were men, 50% had hypertension, 21% diabetes, and 20% chronic pulmonary disease; 29% had no chronic comorbidity. Invasive mechanical ventilation was used in 82%, vasopressors in 83%, renal replacement therapy in 26%, and extra corporeal membrane oxygenation in 8%. ICU stay was median 13 days (IQR 6‐22) and hospital stay 19 days (11‐30). Median follow‐up was 79 days. At end of follow‐up, 118 had died (37%), 15 (4%) were still in hospital hereof 4 in ICU as of 16 June 2020. Risk factors for mortality included male gender, age, chronic pulmonary disease, active cancer, and number of co‐morbidities. Conclusions: In this nationwide, population‐based cohort of ICU patients with COVID‐19, longer term survival was high despite high age and substantial use of organ support. Male gender, age, and chronic co‐morbidities, in particular chronic pulmonary disease, were associated with increased risk of death. [ABSTRACT FROM AUTHOR]

Background: Patients undergoing emergency abdominal surgery are at high risk of post-operative complications. Although post-operative treatment at an intermediate care unit may improve early outcome, there is a lack of studies on the long-term effects of such therapy. The aim of this study was to assess the long-term effect of intermediate care versus standard surgical ward care on mortality in the Intermediate Care After Emergency Abdominal Surgery (InCare) trial.Methods: We included adult patients undergoing emergency major laparoscopy or laparotomy with an Acute Physiology and Chronic Health Evaluation (APACHE) II score of 10 or more, who participated in the InCare trial from October 2010 to November 2012. In the InCare trial, patients were randomized to either post-operative intermediate care or standard surgical ward care. The primary outcome was time to death within 6 years after surgery. We assessed mortality with Coxregression analysis.Results: A total of 286 patients were included. The all-cause 6-year landmark mortality was 52.8% (76 of 144 patients) in the intermediate care group and 47.9% (68 of 142 patients) in the ward care group. There was no statistically significant difference in mortality risk between the two groups (hazard ratio 1.06 (95% confidence interval 0.76-1.47), P = .73).Conclusion: We found no statistically significant difference in 6-year mortality between patients randomized to post-operative intermediate care or ward care after emergency abdominal surgery. However, we detected an absolute mortality risk reduction of 5% in favour of ward care, possibly due to random error. [ABSTRACT FROM AUTHOR]

Background: Neuromuscular monitoring is recommended whenever a neuromuscular blocking agent is administered, but surveys have demonstrated inconsistent monitoring practices. Using qualitative methods, we aimed to explore barriers and aids to routine neuromuscular monitoring and consistent reversal practice.Methods: Focus group interviews were conducted to obtain insights into the thoughts and attitudes of individual anaesthetists, as well as the influence of colleagues and department culture. Interviews were conducted at five Danish and one US hospital. Data were analysed using template analysis.Results: Danish anaesthetists used objective neuromuscular monitoring when administering a non-depolarizing relaxant, but had challenges with calibrating the monitor and sometimes interpreting measurements. Residents from the US institution used subjective neuromuscular monitoring, objective neuromuscular monitoring was generally not available and most had not used it. Danish anaesthetists used neuromuscular monitoring to assess readiness for extubation, whereas US residents used subjective neuromuscular monitoring, clinical tests like 5-second head lift and ventilatory parameters. The residents described a lack of consensus between senior anaesthesiologists in reversal practice and monitoring use. Barriers to consistent and correct neuromuscular monitoring identified included unreliable equipment, time pressure, need for training, misconceptions about pharmacokinetics of neuromuscular blocking agents and residual block, lack of standards and guidelines and departmental culture.Conclusion: Using qualitative methods, we found that though Danish anaesthetists generally apply objective neuromuscular monitoring routinely and residents at the US institution often apply subjective neuromuscular monitoring, barriers to consistent and correct use still exist. [ABSTRACT FROM AUTHOR]

Background: Cardiac surgery is associated with a risk of complications, including post-operative cognitive dysfunction (POCD). In the randomized Perfusion Pressure Cerebral Infarcts (PPCI) trial, we allocated cardiac surgery patients to either a low-target mean arterial pressure (40-50 mm Hg) or a high-target pressure (70-80 mm Hg). The study found no difference in the volume of new ischemic cerebral lesions nor POCD, but 30-day mortality tended to be higher in the high-target group. In the present study we did a long-term 3-year follow-up to assess survival and level of cognitive functioning. The primary hypothesis was that patients allocated to a high-target blood pressure had a higher long-term mortality at 3-year follow-up.Methods: We determined long-term mortality of patients included in the PPCI trial at 3-year follow-up using national registries and we assessed POCD using a cognitive test battery. Subjective level of functioning was assessed with questionnaires. POCD and subjective functioning at follow-up were evaluated in logistic regression models.Results: Among the 197 patients who participated in the original study, there was no significant difference in mortality over a median of 3.4 years according to blood pressure target during cardiopulmonary bypass (hazards ratio 1.23 [high vs low] 95% confidence interval: 0.50-3.02, P = .65). POCD was found in 18.9% and 14.0% in the high-target and low-target groups, respectively adjusted odds ratio 1.01 (CI 95% 0.33-3.12). No differences were found for subjective functioning between groups.Conclusions: No difference in mortality nor in the level of cognitive functioning was found according to blood pressure target during cardiac surgery long-term at 3-year follow-up. [ABSTRACT FROM AUTHOR]

Background: In Europe 700.000 new cases of sepsis occur annually and more than 100.000 of these patients die due to multiorgan failure (MOF). We have identified shock-induced endotheliopathy (SHINE) to be associated with development of MOF and mortality. Furthermore, in patients with septic shock those with circulating levels of thrombomodulin (TM) above 10 ng/mL have twice the mortality (56% vs 28%) than those with levels below this level. Pilot studies indicate that infusion of iloprost (1 ng/kg/min) is associated with improved endothelial function in patients with septic shock.Material and Methods: This is a multicenter, randomized, blinded, investigator-initiated, adaptive phase 2B trial in up to 384 patients with septic shock-induced endotheliopathy defined by TM > 10 ng/mL who are allocated 1:1 to 72 hours continuous infusion of iloprost 1 ng/kg/min or placebo (equal volume of saline). The primary outcome is the mean daily modified Sequential Organ Failure Assessment (SOFA) score in the ICU up to day 90. Secondary outcomes include 28- and 90-day all-cause mortality, days alive without vasopressor in the ICU within 90 days, days alive without mechanical ventilation in the ICU within 90 days, days alive without renal replacement therapy in the ICU within 90 days, numbers of serious adverse reactions, and the number of serious adverse events within the first 7 days.Discussion: This trial tests the safety and efficacy of iloprost vs placebo for 72 hours in patients with septic shock and SHINE. The outcome measures focus on the potential effect of the intervention to mitigate organ failure.Trial Registration: COMBAT-SHINE trial-EudraCT no. 2019-001131-31-Clinicaltrials.gov: NCT04123444-Ethics Committee no. H-19018258. [ABSTRACT FROM AUTHOR]

Background: Emergence Delirium (ED) is a common complication from anesthesia. Although ED has a short duration, detection is important due to the risk that ED poses for post-operative complications in the child. The Pediatric Anesthesia Emergence Delirium (PAED) scale has been translated into Danish, but it has not yet been validated. The aim of this study was to investigate the inter-rater reliability, criterion validity, and responsiveness of the Danish version of the PAED scale as well as to determine the prevalence of ED.Method: A sample of 100 post-operative children were enrolled and assessed with the PAED scale at pre-specified time intervals. Inter-rater reliability was assessed independently by 2 raters. For criterion validity, a clinical expert was chosen as the gold standard. Sensitivity and specificity were based on a comparison between the scoring of the raters and the gold standard. Responsiveness was assessed by comparing changes in scores. Prevalence was based on the PAED scale's cut-off level of ≥10 points.Results: A high level of agreement was found, with an intraclass correlation coefficient of 0.85-0.94. Few outliers appeared in the Bland-Altman plot. Sensitivity ranged from 70% to 86%, and the specificity of both raters against the gold standard was 100%. Changes in scores were indicative of responsiveness. Prevalence was 13.2%.Conclusion: The Danish version of the PAED scale was found reliable and demonstrated high levels of sensitivity and specificity. In addition, it was possible to identify changes in scores over time. Prevalence was in line with existing literature. [ABSTRACT FROM AUTHOR]

Presents an abstract of the research paper 'PaO[sub 2] During Anaesthesia And Years of Smoking Predicts Late Postoperative Hypoxaemia and Complications After Upper Abdominal Surgery in Cardiopulmonary Healthy Patients,' by Jorn Wetterslev, Egon Godthab Hansen, Michael Kamp-Jensen, Ole Roikjaer and Inge-Lis Kanstrup presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Background: Chronic pain has serious consequences for individuals and society. In addition, opioid prescription for chronic non-cancer pain (CNCP) has become more frequent. This study aims to examine the trends regarding the prevalence of CNCP, dispensed opioids, and concurrent use of benzodiazepine (BZD)/BZD-related drugs in the Danish population.Methods: Data from the cross-sectional national representative Danish Health and Morbidity Surveys (2000, 2005, 2010, and 2013) were combined with The Danish National Prescription Registry at an individual level. The study populations varied between 5000 and 13,000 individuals ≥16 years (response rates: 51-63%). Respondents completed a self-administered questionnaire, which included the analyzed items on identification of chronic pain (≥6 months).Results: From 2000 to 2013, the prevalence of CNCP increased and subsequently the annual prevalence of opioid use from 4.1% to 5.7% among CNCP individuals. Higher CNCP prevalence was related to female gender, no cohabitation partner, short education, non-Western origin, and overweight/obesity. In addition, women with CNCP, especially >65 years, became more frequent users of opioids and used higher doses than men. Concurrent use of BZD/BZD-related drugs decreased (13%) from 2010 to 2013, still one-third of long-term opioid user were co-medicated with these drugs.Conclusions: The use of opioids has increased in Denmark, especially among elderly women. The concurrent use of BZD/BZD-related drugs has decreased from 2010 to 2013, but still one-third of long-term opioid users were co-medicated. [ABSTRACT FROM AUTHOR]

Background Perforated peptic ulcer is a serious emergency surgical condition. The aim of the present nationwide cohort study was to evaluate the association between mortality and out-of-hours admission in patients surgically treated for perforated peptic ulcer. Methods All Danish patients surgically treated for benign gastric or duodenal perforated peptic ulcer in Denmark between September 1, 2011 and August 31, 2013 were included. Patients were identified through The Danish Clinical Register of Emergency Surgery. The association between 90-day mortality and time and day of admission and surgery was assessed by crude and adjusted odds ratios ( ORs) with 95% confidence intervals ( CIs). Results A total of 726 patients were included. Median age was 69.5 years (range 18.2-101.7), and 569 of the 726 patients (78.4%) had at least one coexisting disease. Adjusted ORs and 95% CIs between 90-day mortality and admission in daytime vs. nighttime and weekday vs. weekend were 1.0 (0.7-1.5) and 1.2 (0.8-1.8), respectively. Adjusted ORs with 95% CI between surgery in daytime vs. nighttime and weekday vs. weekend were 0.9 (0.6-1.3) and 1.2 (0.8-1.8), respectively. Sensitivity analysis was consistent with the primary analysis. The overall 90-day mortality rate was 25.6% (186/726). Conclusion No statistically significant adjusted association between 90-day mortality and out-of-hours admission was found in patients surgically treated for perforated peptic ulcer. [ABSTRACT FROM AUTHOR]

Presents an abstract of the research paper 'Magnesium Sulphate; Mode of Action, Indications, Dosing Principles, Monitoring and Implications for Anesthesia (in pre-eclampsia and eclampsia),' by Paul Howell, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Failed Spinal or Epidural Anesthesia for Caesarian Section. How to Proceed,' by Lars Irestedt, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Sevoflurane and Desflurane in Obstetric Anaesthesia,' by David Bogod, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Antibiotic Strategies in the Septic Patients. Why Should We Use the Narrow Spectrum Strategy,' by Jens Otto Jarlov, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Infiltration Analgesia — facts or fantasy, by Steen Moiniche, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Use of Antibiotics in Intensive Care Units,' by Jan Bonde, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Prehospital Treatment of Severely Traumatized Patients, Including Patients with Neuro and Cerebral Trauma; Guidelines, News, and Controversies,' by C.M. Grande, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Acute Pain Services: What Is the Documentation for the Value and What Is the Role for the Future?,' by Narinder Rawal, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Human Experimental Pain Models — Can They Be Used to Change Clinical Practice, by Juri Lindy Pedersen, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Evaluation of the Cardiac Patient for Major Non-Cardiac Surgery,' by Pierre Foëx, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'The Coronary Circulation — What is New?,' by Pierre Foëx, presented during the Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Beneficial Effects of Melagatran, a Novel Inhibitor of Thrombin, in the Endotoxemic Pig,' Mats Eriksson, Tom Saldeen, Christer Mattsso and Anders Larsson presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Hypotensive Epidural Anesthesia for Total Hip Replacement,' Nigel E. Sharrock, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'A Dual Mode Operated Antimony Electrode For Simultaneous Determination of pH or PCO[sub 2] and PO[sub 2],' by Folke Sjoberg and Gert Nilsson, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Intravenous Catheters in Children; Tricks of the trade, Technique, Material and Complications,' by Steen W. Henneberg and Krister Nilsson, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Intravenous Anesthesia in Paediatric Patients,' by Per Westrin, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Early Inflammatory Response-Induced Lipid Peroxidation during Endotoxemia,' by Samar Basu and Mats Eriksson, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Monitoring Intraoperative Myocardial Ischaemia,' by Christian Lindskov Christiansen, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Implications of Silent Myocardial Ischaemia,' by Pierre Foëx presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Update in Current Concepts in Trauma Anesthesia and Critical Care: A Personal Perspective,' by C.M. Grande, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'The Inflammatory Response to Sepsis and Surgery—Cellular Aspects,' by Palle Toft, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Morphine, Stress and Immunity,' by Thomas V. Bilfinger presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Cellular Activation During ECC,' by Hanne B. Ravn, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Anaphylactic Reactions in Anesthesia and Intensive care,' by Jerrold H. Levy presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents abstracts of the research paper 'Evidence Based Treatment of PONV,'by Martin R. Tram&eacuter, presented during the Scandinavian Society of Anesthesiologists 25th Congress in Arhus, Denmark.

A calendar of events related to anaesthesiology is presented, which includes the ESRA Scandinavian Zone Meeting in Oslo, Norway, from October 9-10, 2009, Airway Management for Anaesthesiologists in Copenhagen, Denmark, from December 3-4, 2009 and 12th Nordic Burn Meeting in Bergen, Norway, from April 15-17, 2010.

Focuses on the historic event for anesthesia in Copenhagen, Denmark on August 26, 1952. Epidemic of acute poliomyelitis; Anesthetist Bjorn Ibsen's establishment of a treatment for the respiratory complications of polio; Use of positive pressure ventilation in a polio epidemic.

Background: Anaphylactoid reactions in anaesthesia are rare and should ideally be investigated in specialist centres. At Gentofte University Hospital, we established such a centre in 1998 as a joint venture between the Departments of Anaesthesiology and Dermatology. We present the methodology, diagnostic algorithm and preliminary results from our centre.Methods: We are open for referral of patients from all of Denmark. Reactions are classified using a three-grade severity scale and all reactions ranging from mild to severe are investigated. Investigations follow a standard step-by-step protocol of in vitro testing and skin testing. Blood samples for tryptase analysis are taken at the time of reaction and a control sample is taken together with samples for specific IgE analysis 2-4 weeks after the reaction. Subsequent skin testing comprises both prick tests and intradermal tests in most cases. Patients are tested with all substances they were exposed to, including antibiotics, colloids, latex and chlorhexidine.Results: A total of 68 patients have been referred to date (July 2001) and 36 have completed investigations. Positive test results were mainly seen in patients with more severe reactions, and there were more men than women in the group with the most severe reactions. Six patients had positive specific IgE, three for penicillin, two for latex and one for thiopental. In all, 21 patients had positive skin tests to various substances, of whom four men with anaphylactic shock tested positive for chlorhexidine. Only one patient has tested positive to a neuromuscular blocking drug (NMBD) so far.Discussion: Our preliminary results appear to differ in two ways from results usually found in this field. Firstly, only one patient has tested positive for a NMBD and secondly, we have had four patients with anaphylactic shock who have tested positive for chlorhexidine. Possible reasons for these differences are discussed. [ABSTRACT FROM AUTHOR]

The aim of the study was to investigate the extent to which the symptoms experienced by advanced cancer patients were covered by the nursing records. On the day of the first contact with our palliative care department, a nursing record was taken, and on this or the following day, 56 patients filled in the questionnaires EORTC Quality of Life Questionnaire (EORTC QLQ-C30), Edmonton Symptom Assessment System (ESAS), and Hospital Anxiety and Depression Scale (HADS). In each patient, the symptomatology reported in the patient-completed questionnaires was compared with the symptomatology mentioned by the nurse in the nursing record. The analysis revealed good concordance concerning pain and poor physical functioning, but patients reported other symptoms or problems much more often than their nurses. Reasons for these discrepancies are discussed. It is suggested that the nurse's knowledge of the patient's symptomatology might gain from more systematic screening or from transfer of information from patient self-assessment questionnaires to the nursing records. [ABSTRACT FROM AUTHOR]

Background: Problems with managing the airways in relation to anaesthesia causes severe morbidity and mortality. A large proportion of these adverse respiratory events is preventable. Still patients continue to die from airway disasters related to anaesthesia, also in Scandinavia. The goal of this study is to identify which efforts are likely to improve this situation.Methods: A questionnaire asking about experience, behaviour and availability of various items of equipment was mailed to all members of the Danish Society of Anaesthesiologists and were returned anonymously.Results: More than 65% of respondents have sufficient access to a flexible fibrescope, but still 17% of specialists have no access and the vast majority (>67%) has little (1-10 times) or no experience in its use for awake intubation. A total of 52-70% knew the basic principles of the ASA difficult airway algorithm, but despite this only 25-50% would perform awake intubation if a difficult intubation was expected. More than 20% of respondents had experienced preventable airway management mishaps. In all, 18-46% did not know how to oxygenate via the cricothyroid membrane.Conclusion: There is room for improvement regarding airway management skills among Danish anaesthesiologists. It is likely that airway management can be improved by: A) Better knowledge of an appropriate plan, algorithm, for airway management. B) Awake intubation used more often. C) More experience in fibreoptic intubation. D) All anaesthesiologists accepting that previous difficult intubation is an indicator of future difficulties. E) All anaesthesiologists knowing, and practising on manikins, how to oxygenate via the cricothyroid membrane. F) Always having a laryngeal mask airway immediately available when inducing anaesthesia. [ABSTRACT FROM AUTHOR]

Presents an abstract of the research paper 'Dramatic Changes in Haemostasis During Pregnancy,' by Jorgen Ingerslev, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Tocolysis. Indications, Effects and Side-Effects of Beta-receptor Agonists, Ca-Blockers, magnesium and nitroglycerine,' by Carsten Lenstrup, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Ecological Consequences of Use/Misuse of Antibiotics,' by Jens K. Moller, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Acute Pain and Outcome: The Second Round Will Require Changes in Tactics,' by Hendrik Kehlet, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'NSAID and Paracetamol — the Role in Postoperative Pain Treatment, by Frederic Camu, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.

Presents an abstract of the research paper 'Study-Subject 'Rescue Service' — The German Notarzt Education and Planning,' by Uwe Krüger, presented during The Scandinavian Society of Anesthesiologists 25th Congress in Aarhus, Denmark.