Læknablaðið - 15.04.2007, Blaðsíða 61

ÞING SKURÐLÆKNA, SVÆFINGA- OG GJÖRGÆSLULÆKNA / ÁGRIP ERINDA
kvarða. VAS <3 var metinn ásættanlegur árangur. Dreypihraði í
ml/klst og notkun verkjalyfja var borin saman milli hópa.
Niðurstöður
Verkjastilling í hvíld/viö hreyfingu <50ára 51-70 ára >70 ára
Fyrsti dagur. VAS<3 í hvíld 86% 93% 92%
Fyrsti dagur. VAS<3 við hreyfingu 62% 66% 74%
Annar dagur VAS<3 í hvíld 90% 95% 93%
Annar dagur VAS<3 við hreyfingu 77% 81% 87%
Dreypihraði á öðrum degi 8,3 ml/klst 8,0 ml/klst 7,25 ml/klst
Notkun ópíatverkjalyfia 43% 29% 25%
Notkun salýlyfja 48% 46% 30%
Ályktun: Verkjastilling var betri, dreypihraði lægri og notkun
sterkra verkjalyfja var minni í eldri aldurshópi en í öðrum
hópum. Ofangreindar klínískar niðurstöður staðfesta því fyrri
rannsóknir.
" Simon MJG el al. Effecl ofage on llie clinical profile and systemic absorbtion and
disposition of levobupivacaine after epidural administration. BJA 2004; 93:512-20.
E-36 Klórgasslys á Eskifirði
Hulda Bima Eiríksdóttirl, Björn Magnússonl, Guðjón Leifur Gunnarsson2,
Hannes Sigmarssonl, Kristinn Tómasson3, Stefán Þórarinssonl
huldaei@visir.is
'Heilbrigðisstofnun Austurlands, :Odense Universitets Hospital, 3Vinnu-
eftirlit ríkisins
Inngangur: Vegna mistaka við áfyllingu á klórtank í Sundlaug
Eskifjarðar í júní 2006 losnaði töluvert magn af klórgasi
út í andrúmsloftið og olli eitrun hjá starfsmönnum og
sundlaugargestum. Einnig barst gasið yfir nærliggjandi leikvöll
og leikskóla.
Efniviður og aðferðir: Gerð var úttekt á slysinu og afleiðingum
þess fyrir einstaklingana sem í því lentu.
Niðurstöður: Alls leituðu 59 manns á heilsugæslu Eskifjarðar
eftir slysið, 34 börn og 25 fullorðnir. Einkenni voru frá vægum
særindum í hálsi og upp í andnauð. Samtals 36 sjúklingar voru
fluttir á Fjórðungssjúkrahúsið á Neskaupsstað. Tveir þeirra
voru fluttir áfram til FSA á gjörgæslu en fjórir á Landspítala
á almennar legudeildir. Björgunaraðgerðir voru með þeim
stærri sem settar hafa verið í gang á landinu. Strax í upphafi var
Samhæfingarstöð Almannavarna virkjuð. Björgunarviðbragðið
krafðist samvinnu margra aðila af öllu landinu. Almenningur
veitti mikilvæga hjálp. Áætlað er að 200-300 manns hafi komið
að aðgerðum með einum eða öðrum hætti.
Ályktun: Umfangsmiklar björgunaraðgerðir voru settar í gang,
bæði í héraði og á landsvísu og reyndi á skipulag almannavarna.
Meirihluti þeirra sem fyrir eitruninni varð jafnaði sig skjótt og
enginn lést.
E-37 Radiological behaviour of a cervical interbody fusion
cage (BAK/C). A randomized clinical study using radioste-
reometry (RSA)
Björn Zoéga', Bengt Lind2
bjornz@landspitali.is
‘Landspítali, Reykjavík, Iceland, 2Sahlgrenska University Hospital,
Göteborg, Sweden
Introduction: To avoid graft collapse with subsequent subsi-
dence and malalignment of a fused segment in cervical spine
degenerative surgery, the use of fusion cages has increased
over the last years. No randomized studies exist that demonst-
rate the difference between the two methods in terms of graft
subsidence and angulation of the fused segment.The aim of this
study was to study subsidence and angulation that occurs after a
single-level discectomy and fusion (ACDF) with autograft or a
threaded fusion cage (BAK/C).
Material and methods: A randomized clinical study using
radiostereometry (RSA) with a 2-years follow-up was
performed. The size of the study population was calculated to
be 24 patients to reach a significant difference at the 95% CI
level. Consecutive patients with one-level cervical radiculopathy
scheduled for surgery were randomized to ACDF with autograft
or to fusion cage. Tantalum markers were inserted in both
adjacent vertebrae at the end of surgery. Radiostereometry was
performed immediately postoperatively and at regular intervals
for 2 years. Questionnaires were used to evaluate the clinical
outcome and an unbiased observer graded the outcome after 2
years.
Results: No significant differences was found between the two
methods after 2 years in regard of narrowing of the disc space
(mean: 1.7 and 1.4 mm respectively) or deformation of the fused
segment into flexion (mean: 7.7° and 4.6° respectively). Patients
in the cage group had a significantly better outcome in terms of
reduction of both arm and neck pain and in Odom’s score.
Discussion: The findings of subsidence and flexion deformation
of the fused segment after 2 years seem to be of no clinical
importance after one level cervical disc surgery. However, in
multi-level surgery using the same methods, an additive effect of
the deformations of the fused segments may affect the clinical
outcome.
E-38 Bone-metal stability of the Bryan disc prosthesis, a
RadioStereometric 2 year Analysis
Björn Zoega1. Bengt Lind2
bjornz@landspitali.is
‘Landspítali, Reykjavík, Iceland, 2Sahlgrenska University Hospital, Göte-
borg, Sweden
Introduction: The effect of usion on adjacent discs in cervical
spine surgery has been postulated to lead to increased stress,
increased motion and increased degeneration on radiography
on adjacent discs. In the early era of artificial disc prosthesis
Fernström balls did not preserve motion but created fusion in
the lumbar spine. The Bryan cervical disc prosthesis uses a de-
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