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Falk, W., Gupta, A., Forssten, M. P., Hjelmqvist, H., Bass, G. A., Matthiessen, P. & Mohseni, S. (2021). Epidural analgesia and mortality after colorectal cancer surgery: A retrospective cohort study. Annals of Medicine and Surgery, 66, Article ID 102414.
Open this publication in new window or tab >>Epidural analgesia and mortality after colorectal cancer surgery: A retrospective cohort study
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2021 (English)In: Annals of Medicine and Surgery, E-ISSN 2049-0801, Vol. 66, article id 102414Article in journal (Refereed) Published
Abstract [en]

Background: Epidural analgesia (EA) has been the standard of care after major abdominal surgery for many years. This study aimed to correlate EA with postoperative complications, short- and long-term mortality in patients with and without EA after open surgery (OS) and minimally invasive surgery (MIS) for colorectal cancer.

Methods: Patient, clinical and outcome data were obtained from the Swedish Colorectal Cancer Registry and the Swedish Perioperative Registry. All adult patients diagnosed with colorectal cancer without metastases who underwent elective curative MIS or OS for colorectal cancer between January 2016 and December 2018 and who had data recorded in both registries, were included in the study. Data were analyzed for OS and MIS procedures separately. A Poisson regression model was used to investigate the association between EA and the outcomes of interest.

Results: Five thousand seven hundred sixty-two patients were included in the study, 2712 in the MIS and 3050 patients in the OS group. After adjusting for patient specific and clinically relevant variables in the regression model, no statistically significant difference in risk for complications; 30-day, 90-day, and up to 3-year mortality following either MIS or OS could be detected between the EA+ and EA-cohorts.

Conclusions: In this large study cohort, EA as part of the comprehensive care provided was not associated with a reduction in postoperative complications risk or improved 30-day, 90-day, or 3-year survival after MIS or OS for colorectal cancer.

Place, publisher, year, edition, pages
Elsevier, 2021
Keywords
Epidural analgesia, Colorectal cancer, Open surgery, Minimally invasive surgery, Mortality
National Category
Anesthesiology and Intensive Care
Research subject
Medicine
Identifiers
urn:nbn:se:oru:diva-92318 (URN)10.1016/j.amsu.2021.102414 (DOI)000670131300005 ()34113442 (PubMedID)2-s2.0-85106895563 (Scopus ID)
Projects
Epidural Analgesia for Colorectal Cancer Surgery: Experimental and Clinical studies
Note

Funding Agency:

ALF funding Region Örebro County OLL-880951

Available from: 2021-06-11 Created: 2021-06-11 Last updated: 2023-10-06Bibliographically approved
Siekmann, W., Tina, E. & Gupta, A. (2017). Concentration-dependent cell viability and proliferation in vitro of colon cancer cell lines SW480 and SW620 on exposure to lidocaine or ropivacaine. Acta Anaesthesiologica Scandinavica, 61(8), 1017-1018
Open this publication in new window or tab >>Concentration-dependent cell viability and proliferation in vitro of colon cancer cell lines SW480 and SW620 on exposure to lidocaine or ropivacaine
2017 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 61, no 8, p. 1017-1018Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Cancer cells change phenotypes and properties when evolving from primary tumor cells to metastatic cells. These changes might affect the response to local anesthetics (LA). The aim of this study was to investigate if lidocaine or ropivacaine have a dose- dependent effect on cell viability and proliferation of a primary and a secondary colon carcinoma cell line in vitro.

Methods: The colon cancer cell lines SW 480, derived from primary tumor and SW620 from metastatic tumor in the same patient, were exposed to increasing log-concentrations of lidocaine and ropivacaine. Cell viability was measured using CellTiter Blue, and cell proliferation by PKH67, after exposure for up to 72 h.

Results: Cell viability was not affected after 24 h of exposure. However, the metastatic cell line SW620 showed a significant increase in cell viability at low concentrati ons after 48 and 72 h. Exposure to the higher, but clinically relevant, concentrations of both LA resulted in decreased cell viability in both cell lines. These higher concentrations also showed an inhibitory effect on cell proliferation after 72 h, which was more pronounced for ropivacaine.

Conclusions: Low concentrations of lidocaine and ropivacaine, as achieved in plasma by epidural infusion of LA, do not have direct antiproliferative effects on these colon cancer cell lines in vitro. Higher concentrations of LA, as during continuous local infiltration into tissues over 72 h, inhibit proliferation of both cancer cell lines. The increase in cell viability seen in SW620 should be investigated and underlying mechanisms further elucidated in future studies.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:oru:diva-59281 (URN)10.1111/aas.12941 (DOI)000407231100098 ()
Available from: 2017-08-29 Created: 2017-08-29 Last updated: 2020-12-01Bibliographically approved
Kuchalik, J., Magnuson, A. F. .., Tina, E. & Gupta, A. (2017). Does local infiltration analgesia reduce peri-operative inflammation following total hip arthroplasty?: A randomized, double-blind study. BMC Anesthesiology, 17, Article ID 63.
Open this publication in new window or tab >>Does local infiltration analgesia reduce peri-operative inflammation following total hip arthroplasty?: A randomized, double-blind study
2017 (English)In: BMC Anesthesiology, ISSN 1471-2253, E-ISSN 1471-2253, Vol. 17, article id 63Article in journal (Refereed) Published
Abstract [en]

Background: Postoperative inflammation following total hip arthroplasty (THA) can lead to delayed mobilization and return of hip function. Our primary aim was to assess whether local infiltration analgesia (LIA) during surgery can prevent postoperative inflammation.

Methods: This is a sub-analysis of data from a broader double-blind study where 56 patients received spinal anaesthesia for THA. Additionally, Group FNB (Femoral Nerve Block) received an ultrasound-guided femoral nerve block using 30 mL of ropivacaine 7.5 mg/mL (225 mg), and 151.5 mL of saline peri-articularly intra-operatively. Group LIA received 30 mL saline in the femoral nerve block and ropivacaine 2 mg/mL, 300 mg (150 mL) + ketorolac 30 mg (1 mL) + adrenaline 0.5 mg (0.5 mL) peri-articularly. After 23 h, the LIA mixture (22 mL) was injected via a catheter placed peri-articularly in Group LIA and 22 mL saline in Group FNB. A battery of pro-and anti-inflammatory cytokines was assessed using a commercially available kit preoperatively and after 4 h and 3 days postoperatively. Additionally, CRP, platelet count and white blood count was determined pre- and postoperatively.

Results: There was a general trend towards an increase in pro-inflammatory cytokines postoperatively, which returned to normal levels after 3 days. IL-6 concentration was significantly lower 4 h postoperatively in Group LIA compared to Group FNB (p = 0.015). No other significant differences were found between the groups in other cytokines. CRP levels were significantly higher in Group FNB compared to Group LIA 3 days postoperatively (p < 0.001). No other significant differences were seen between the groups.

Conclusion: Local infiltration analgesia has a modest but short-lasting effect on postoperative inflammation in patients undergoing total hip arthroplasty. This is likely to be due to local infiltration of ketorolac and/or local anaesthetics in the LIA mixture. Future studies should be directed towards assessing whether the use of LIA translates into better patient outcomes.

Place, publisher, year, edition, pages
BioMed Central, 2017
Keywords
Total hip arthroplasty, Local infiltration analgesia, Postoperative inflammation
National Category
Anesthesiology and Intensive Care Surgery
Identifiers
urn:nbn:se:oru:diva-57862 (URN)10.1186/s12871-017-0354-y (DOI)000400426200001 ()28468607 (PubMedID)2-s2.0-85018738510 (Scopus ID)
Note

Funding Agency:

Research Committee, orebro University HospitaL  OLL-590351

Available from: 2017-05-31 Created: 2017-05-31 Last updated: 2020-12-01Bibliographically approved
Kuchalik, J., Magnuson, A., Lundin, A. & Gupta, A. (2017). Local infiltration analgesia: a 2-year follow-up of patients undergoing total hip arthroplasty. Journal of Anesthesia, 31(6), 837-845
Open this publication in new window or tab >>Local infiltration analgesia: a 2-year follow-up of patients undergoing total hip arthroplasty
2017 (English)In: Journal of Anesthesia, ISSN 0913-8668, E-ISSN 1438-8359, Vol. 31, no 6, p. 837-845Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Local infiltration analgesia (LIA) is commonly used for postoperative pain management following total hip arthroplasty (THA). However, the long-term effects of the component drugs are unclear. The aim of our study was to investigate functional outcome, quality of life, chronic post-surgical pain, and adverse events in patients within 2 years of undergoing THA.

METHODS: The study was a secondary analysis of data from a previous larger study. Eighty patients were randomized to receive either intrathecal morphine (Group ITM) or local infiltration analgesia (Group LIA) for pain management in a double-blind study. The parameters measured were patient-assessed functional outcome [using the Hip dysfunction and Osteo-arthritis Outcome Score (HOOS) questionnaire], health-related quality of life [using the European Quality of Life-5 dimensions (EQ-5D) questionnaire and the 36-Item Short Form Health Survey (SF-36) score], and pain using the numeric rating score (NRS), with persistent post-surgical pain having a NRS of > 3 or a HOOS pain sub-score of > 30. All complications and adverse events were investigated during the first 2 years after primary surgery.

RESULTS: Pain intensity and rescue analgesic consumption were similar between the groups after hospital discharge. No differences were found in HOOS or SF-36 score between the groups up to 6 months after surgery. A significant group × time interaction was seen in the EQ 5D form in favor of the LIA group. No between-group difference in persistent post-surgical pain was found at 3 or 6 months, or in adverse events up to 2 years after surgery.

CONCLUSION: Analysis of functional outcome, quality of life, and post-discharge surgical pain did not reveal significant differences between patients receiving LIA and those receiving ITM. LIA was found to be a safe technique for THA during the long-term follow-up. However, it should be noted that these conclusions are based on a limited number of patients.

Place, publisher, year, edition, pages
Springer Japan KK, 2017
Keywords
Local anesthetics; Quality of life; Total hip arthroplasty; Postoperative complications
National Category
Anesthesiology and Intensive Care
Identifiers
urn:nbn:se:oru:diva-61185 (URN)10.1007/s00540-017-2403-6 (DOI)000415131600006 ()28856511 (PubMedID)2-s2.0-85028593809 (Scopus ID)
Available from: 2017-09-29 Created: 2017-09-29 Last updated: 2018-08-06Bibliographically approved
Siekmann, W., Eintrei, C., Magnuson, A., Sjölander, A., Matthiessen, P., Myrelid, P. & Gupta, A. (2017). Surgical and not analgesic technique affects postoperative inflammation following colorectal cancer surgery: a prospective, randomized study. Colorectal Disease, 19(6), O186-O195
Open this publication in new window or tab >>Surgical and not analgesic technique affects postoperative inflammation following colorectal cancer surgery: a prospective, randomized study
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2017 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 19, no 6, p. O186-O195Article in journal (Refereed) Published
Abstract [en]

AIM: Epidural analgesia reduces the surgical stress response. However, its effect on pro- and anti-inflammatory cytokines in the genesis of inflammation following major abdominal surgery remains unclear. Our main objective was to elucidate whether perioperative epidural analgesia prevents the inflammatory response following colorectal cancer surgery.

METHODS: 96 patients scheduled for open or laparoscopic surgery were randomized to epidural analgesia (group E) or patient controlled intravenous analgesia (group P). Surgery and anaesthesia were standardized in both groups. Plasma cortisol, insulin and serum cytokines (IL-1β,IL-4,IL-5,IL-6,IL-8,IL-10,IL-12p70,IL-13,TNFα,IFNγ,GM-CSF,PGE2 and VEGF) were measured preoperatively (T0), 1-6 hours postoperatively (T1) and 3-5 days postoperatively (T2). Mixed model analysis was used, after logarithmic transformation when appropriate, for analyses of cytokines and stress markers.

RESULTS: There were no significant differences in any serum cytokine concentration between groups P and E at any time point except in IL-10 which was 87% higher in group P (median and range 4.1 (2.3-9.2) pg/ml,) compared to group E (2.6 (1.3-4.7) pg/ml) (p=0.002) at T1. There was no difference in plasma cortisol and insulin between the groups at any time point after surgery. Significant difference in median serum cytokine concentration was found between open and laparoscopic surgery with higher levels of IL-6,IL-8 and IL-10 at T1 in patients undergoing open surgery compared to laparoscopic surgery. No difference in serum cytokine concentration was detected between the groups or between the surgical technique at T2.

CONCLUSIONS: Open surgery, compared to laparoscopic surgery, has greater impact on these inflammatory mediators than epidural analgesia vs. intravenous analgesia. This article is protected by copyright. All rights reserved.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
Anaesthesia, epidural, surgery, colorectal cancer, inflammation, cytokines
National Category
Anesthesiology and Intensive Care Surgery
Research subject
Oncology; Surgery; Anaesthesiology
Identifiers
urn:nbn:se:oru:diva-57387 (URN)10.1111/codi.13643 (DOI)000402674400003 ()28258664 (PubMedID)2-s2.0-85018758511 (Scopus ID)
Note

Funding Agency:

Regional Research Committee, Örebro-Uppsala Region, Sweden

Available from: 2017-05-03 Created: 2017-05-03 Last updated: 2022-02-11Bibliographically approved
Axelsson, B., Häggmark, S., Svenmarker, S., Johansson, G., Gupta, A., Tydén, H., . . . Haney, M. (2016). Effects of Combined Milrinone and Levosimendan Treatment on Systolic and Diastolic Function During Postischemic Myocardial Dysfunction in a Porcine Model. Journal of Cardiovascular Pharmacology and Therapeutics, 21(5), 495-503
Open this publication in new window or tab >>Effects of Combined Milrinone and Levosimendan Treatment on Systolic and Diastolic Function During Postischemic Myocardial Dysfunction in a Porcine Model
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2016 (English)In: Journal of Cardiovascular Pharmacology and Therapeutics, ISSN 1074-2484, E-ISSN 1940-4034, Vol. 21, no 5, p. 495-503Article in journal (Refereed) Published
Abstract [en]

It is not known whether there are positive or negative interactions on ventricular function when a calcium-sensitizing inotrope is added to a phosphodiesterase inhibitor in the clinical setting of acute left ventricular (LV) dysfunction. We hypothesized that when levosimendan is added to milrinone treatment, there will be synergetic inotropic and lusitropic effects. This was tested in an anesthetized porcine postischemic global LV injury model, where ventricular pressures and volumes (conductance volumetry) were measured. A global ischemic injury was induced by repetitive left main stem coronary artery occlusions. Load-independent indices of LV function were assessed before and after ventricular injury, after milrinone treatment, and finally after addition of levosimendan to the milrinone treatment. Nonparametric, within-group comparisons were made. The protocol was completed in 12 pigs, 7 of which received the inotrope treatment and 5 of which served as controls. Milrinone led to positive lusitropic effects seen by improvement in tau after myocardial stunning. The addition of levosimendan to milrinone further increased lusitropic state. The latter effect could however not be attributed solely to levosimendan, since lusitropic state also improved spontaneously in time-matched controls at the same rate during the corresponding period. When levosimendan was added to milrinone infusion, there was no increase in systolic function (preload recruitable stroke work) compared to milrinone treatment alone. We conclude that in this model of postischemic LV dysfunction, there appears to be no clear improvement in systolic or diastolic function after addition of levosimendan to established milrinone treatment but also no negative effects of levosimendan in this context.

Place, publisher, year, edition, pages
Thousand Oaks, USA: Sage Publications, 2016
Keywords
Experimental and clinical heart failure, ischemia–reperfusion injury, cardiac pharmacology, cardioactive agents
National Category
Cardiac and Cardiovascular Systems
Research subject
Cardiology
Identifiers
urn:nbn:se:oru:diva-52002 (URN)10.1177/1074248416628675 (DOI)000382567800008 ()26837238 (PubMedID)2-s2.0-84982952709 (Scopus ID)
Funder
Swedish Heart Lung Foundation
Note

Funding Agencies:

Örebro County Council, Örebro

Umeå University, Umeå, Sweden

Available from: 2016-09-07 Created: 2016-09-06 Last updated: 2019-03-01Bibliographically approved
Darvish, B., Dahlgren, G., Irestedt, L., Magnuson, A., Möller, C. & Gupta, A. (2015). Auditory function following post dural puncture headache treated with epidural blood patch A long-term follow-up of parturients. Paper presented at 33rd Congress of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine, Reykjavik, Iceland, June 10, 2015. Acta Anaesthesiologica Scandinavica, 59, 24-25
Open this publication in new window or tab >>Auditory function following post dural puncture headache treated with epidural blood patch A long-term follow-up of parturients
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2015 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 59, p. 24-25Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Hoboken, USA: Wiley-Blackwell, 2015
National Category
Anesthesiology and Intensive Care
Research subject
Anaesthesiology
Identifiers
urn:nbn:se:oru:diva-45305 (URN)000356009400069 ()
Conference
33rd Congress of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine, Reykjavik, Iceland, June 10, 2015
Available from: 2015-07-22 Created: 2015-07-20 Last updated: 2024-01-03Bibliographically approved
Darvish, B., Dahlgren, G., Irestedt, L., Magnuson, A., Möller, C. & Gupta, A. (2015). Auditory function following post-dural puncture headache treated with epidural blood patch: a long-term follow-up. Acta Anaesthesiologica Scandinavica, 59(10), 1340-1354
Open this publication in new window or tab >>Auditory function following post-dural puncture headache treated with epidural blood patch: a long-term follow-up
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2015 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 59, no 10, p. 1340-1354Article in journal (Refereed) Published
Abstract [en]

Background: Epidural analgesia is commonly used for pain management during labor. Sometimes, accidental dural puncture (ADP) occurs causing severely debilitating headache, which may be associated with transient hearing loss. We investigated if auditory function may be impaired several years after ADP treated with epidural blood patch (EBP).

Methods: Sixty women (ADP group) without documented hearing disability, who received EBP following ADP during labor between the years 2005-2011 were investigated in 2013 for auditory function using the following tests: otoscopic examination, tympanometry, pure tone audiometry, and transient-evoked otoacoustic emissions. Additionally, they responded to a questionnaire, the Speech, Spatial and Qualities (SSQ) of hearing, concerning perceived hearing impairment. The results were compared to a control group of 20 healthy, non-pregnant women in the same age group.

Results: The audiometric test battery was performed 5.2 (1.9)years after delivery. No significant differences were found between the ADP and the control groups in tympanometry or otoacoustic emissions. Pure tone audiometry revealed a significant but small (<5dB) difference between the ADP and control groups (P<0.05). The ability to hear speech in noise as measured by SSQ was significantly reduced in the ADP group compared to the control group (P<0.05).

Conclusions: A minor hearing loss was detected in the ADP group compared to the control group in pure tone audiometry in some women and during speech-in-noise component several years after accidental dural puncture treated with an epidural blood patch. This small residual hearing loss has minor clinical significance.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2015
National Category
Anesthesiology and Intensive Care
Research subject
Anaesthesiology
Identifiers
urn:nbn:se:oru:diva-46393 (URN)10.1111/aas.12566 (DOI)000362589100014 ()26105531 (PubMedID)2-s2.0-84943362300 (Scopus ID)
Available from: 2015-11-04 Created: 2015-11-04 Last updated: 2018-07-23Bibliographically approved
Sagerfors, M., Gupta, A., Brus, O., Rizzo, M. & Pettersson, K. (2015). Patient related functional outcome after total wrist arthroplasty: a single center study of 206 cases. Hand Surgery, 20(1), Article ID 81.
Open this publication in new window or tab >>Patient related functional outcome after total wrist arthroplasty: a single center study of 206 cases
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2015 (English)In: Hand Surgery, ISSN 0218-8104, Vol. 20, no 1, article id 81Article in journal (Refereed) Published
Abstract [en]

Objectives: To prospectively evaluate patient related outcome measures after total wrist arthroplasty (TWA) using four different total wrist implants operated at a single referral center in Sweden.

Methods: 206 primary TWAs were assessed preoperatively and after one year postoperatively with respect to the following eight outcome measures: Range of motion (flexion/extension, radial/ulnar deviation, pronation/supination), hand grip strength, Canadian Occupational Performance Measure (COPM), performance and satisfaction, Visual Analog Scale (VAS) pain scores at rest and in activity.

Results: The Maestro TWA had a significantly greater improvement of radial/ulnar deviation than the Biax and Remotion TWAs. COPM performance and satisfaction improved more for the Maestro and Universal 2 prostheses than the Biax and Remotion.

Conclusions All four TWAs offer reduced VAS-scores and improved COPM-scores with preserved hand grip strength and somewhat improved range of motion. The Maestro TWA performed favorably compared to the Remotion TWA. Implant design may affect patient related outcome.

Place, publisher, year, edition, pages
Singapore: World Scientific Publishing, 2015
Keywords
Arthroplasty, Rheumatoid, Total Wrist, Joint
National Category
Surgery
Research subject
Surgery
Identifiers
urn:nbn:se:oru:diva-52144 (URN)10.1142/S0218810415500112 (DOI)000216862600012 ()25609279 (PubMedID)2-s2.0-84941743295 (Scopus ID)
Available from: 2016-09-13 Created: 2016-09-13 Last updated: 2019-03-26Bibliographically approved
Jaensson, M., Gupta, A. & Nilsson, U. (2014). Gender differences in sore throat and hoarseness following endotracheal tube or laryngeal mask airway: a prospective study. BMC Anesthesiology, 14(56)
Open this publication in new window or tab >>Gender differences in sore throat and hoarseness following endotracheal tube or laryngeal mask airway: a prospective study
2014 (English)In: BMC Anesthesiology, ISSN 1471-2253, E-ISSN 1471-2253, Vol. 14, no 56Article in journal (Refereed) Published
Abstract [en]

Background and objective. Postoperative sore throat and hoarseness are common minor complications following airway manipulation. This study was primarily done to determine gender differences in the incidence of these symptoms and the location of POST after laryngeal mask airway (LMA) and endotracheal tube (ETT).

Methods. A total of 112 men and 185 women were included during a four month period. All patients were evaluated postoperatively and after 24 hours about the occurrence of sore throat, its location and hoarseness. If the patients had any symptom, they were followed-up at 48, 72 and 96 hours until the symptoms resolved.

Results. There was no significant gender difference in postoperative sore throat (POST) and postoperative hoarseness (PH) when analyzing both airway devices together. The incidence of sore throat and hoarseness were higher postoperatively after an ETT than an LMA (32% vs. 19%, p= 0.012) and 57% vs. 33% (p< 0.001) respectively. Significantly more women than men had POST after an LMA (26% vs. 6%, p=0.004). No significant gender difference was found in either POST or PH after an ETT or in the incidence of PH after an LMA. More patients located their pain below the larynx after an ETT vs. an LMA (24% vs. 4%). Pain above the larynx was more common after an LMA than an ETT (52 % vs. 37 %).

Conclusions.  In a clinical setting where women are intubated with a smaller size ETT than men, there were no significant differences in POST or PH between genders. Additionally, more women than men have POST when an LMA is used. Awareness of POST and PH may help streamline patients in whom the best airway device could be used during anesthesia and surgery.

Place, publisher, year, edition, pages
BioMed Central, 2014
Keywords
Endotracheal tube, Hoarseness, Laryngeal mask airway, Postoperative complications, Sore throat
National Category
Nursing Anesthesiology and Intensive Care
Research subject
Anaesthesiology; Caring sciences
Identifiers
urn:nbn:se:oru:diva-36053 (URN)10.1186/1471-2253-14-56 (DOI)000339519600001 ()25061426 (PubMedID)2-s2.0-84904730639 (Scopus ID)
Note

Funding Agency:

Research Committee, Örebro county council, Örebro, Sweden 

Available from: 2014-08-21 Created: 2014-08-21 Last updated: 2020-12-01Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6128-7752

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