Mats Enlund | Uppsala University (original) (raw)
Papers by Mats Enlund
Anesthesiology, Mar 11, 2024
BJA: British Journal of Anaesthesia, Jun 1, 1996
Anesthesia & Analgesia, 2000
Low incidence of side effects after spinal anesthesia with heavy lignocaine through a Quincke needle
British Journal of Anaesthesia, 2003
Molecular Brain, 2013
Background Opioids are associated with wide inter-individual variability in the analgesic respons... more Background Opioids are associated with wide inter-individual variability in the analgesic response and a narrow therapeutic index. This may be partly explained by the presence of single nucleotide polymorphisms (SNPs) in genes encoding molecular entities involved in opioid metabolism and receptor activation. This paper describes the investigation of SNPs in three genes that have a functional impact on the opioid response: OPRM1, which codes for the μ-opioid receptor; ABCB1 for the ATP-binding cassette B1 transporter enzyme; and the calcium channel complex subunit CACNA2D2. The genotyping was combined with an analysis of plasma levels of the opioid peptide β-endorphin in 80 well-defined patients with chronic low back pain scheduled for spinal fusion surgery, and with differential sensitivity to the opioid analgesic remifentanil. This patient group was compared with 56 healthy controls. Results The plasma β-endorphin levels were significantly higher in controls than in pain patients. ...
Journal of Oral and Maxillofacial Surgery, 1998
Journal of Internal Medicine, 2013
In a review based on estimations and assumptions, to report the estimated number of survivors aft... more In a review based on estimations and assumptions, to report the estimated number of survivors after out-of-hospital cardiac arrest (OHCA) in whom cardiopulmonary resuscitation (CPR) was started and to speculate about possible future improvements in Sweden. An observational study. All ambulance organisations in Sweden. Patients included in the Swedish Cardiac Arrest Registry who suffered an OHCA between January 1, 2008 and December 31, 2010. Approximately 80% of OHCA cases in Sweden in which CPR was started are included. None In 11 005 patients, the 1-month survival rate was 9.4%. There are approximately 5000 OHCA cases annually in which CPR is started and 30-day survival is achieved in up to 500 patients yearly (6 per 100 000 inhabitants). Based on findings on survival in relation to the time to calling for the Emergency Medical Service (EMS) and the start of CPR and defibrillation, it was estimated that, if the delay from collapse to (i) calling EMS, (ii) the start of CPR, and (iii) the time to defibrillation were reduced to <2 min, <2 min, and <8 min, respectively, 300-400 additional lives could be saved. Based on findings relating to the delay to calling for the EMS and the start of CPR and defibrillation, we speculate that 300-400 additional OHCA patients yearly (4 per 100 000 inhabitants) could be saved in Sweden.
European Journal of Pain, 2006
European Journal of Anaesthesiology, 1997
... PET scanning What can it Tell us about Anaesthesia? Per Hartvig, Jesper Andersson, Arne Wes... more ... PET scanning What can it Tell us about Anaesthesia? Per Hartvig, Jesper Andersson, Arne Wessén, Mats Enlund, Lars Wiklund, Sven Valind and Bengt Långström Copyright Year:1998 ISBN: 978-1-84755-096-5 DOI:10.1039 ...
British Journal of Anaesthesia, 2003
Upsala Journal of Medical Sciences, 1996
European Journal of Anaesthesiology, 1997
Anesthesiology, 2003
Background The use of 100% oxygen during induction of anesthesia may produce atelectasis. The aut... more Background The use of 100% oxygen during induction of anesthesia may produce atelectasis. The authors investigated how different oxygen concentrations affect the formation of atelectasis and the fall in arterial oxygen saturation during apnea. Methods Thirty-six healthy, nonsmoking women were randomized to breathe 100, 80, or 60% oxygen for 5 min during the induction of general anesthesia. Ventilation was then withheld until the oxygen saturation, assessed by pulse oximetry, decreased to 90%. Atelectasis formation was studied with computed tomography. Results Atelectasis in a transverse scan near the diaphragm after induction of anesthesia and apnea was 9.8 +/- 5.2 cm2 (5.6 +/- 3.4% of the total lung area; mean +/- SD), 1.3 +/- 1.2 cm2 (0.6 +/- 0.7%), and 0.3 +/- 0.3 cm2 (0.2 +/- 0.2%) in the groups breathing 100, 80, and 60% oxygen, respectively (P < 0.01). The corresponding times to reach 90% oxygen saturation were 411 +/- 84, 303 +/- 59, and 213 +/- 69 s, respectively (P < ...
Anesthesia & Analgesia, 2006
To the Editor:Drs. Eger and Sonner (1) recently raised the question: is recall more likely during... more To the Editor:Drs. Eger and Sonner (1) recently raised the question: is recall more likely during IV versus inhaled anesthesia? There is no proper answer, but some findings indicate that the answer is no, as using the most (only) used diagnostic instrument for awareness detection, the structured int
The need for induced hypotension in orthognathic surgery was evaluated. Blood loss, duration of o... more The need for induced hypotension in orthognathic surgery was evaluated. Blood loss, duration of operation, quality of the surgical field, and surgical result were measured in 36 patients, assigned to either hypotension (mean arterial pressure, MAP, 50-64 mmHg) or normotension (MAP > or = 65 mmHg). Hypotension was achieved by increasing the amount of isoflurane given. The hypotensive group had significantly less bleeding over time (mean 0.9 ml/minute, 95% confidence interval (CI) of mean 0.6 to 1.2, compared with 1.8, 95% CI 1.3 to 2.4, p = 0.005). The corresponding difference in total blood loss did not differ significantly between the groups (mean 186 ml, 95% CI 98 to 275, compared with 304, 95% CI 210 to 399). No patient required transfusion of red cells. Neither the duration of surgery, nor the quality of the surgical field, nor the final result were significantly influenced by hypotension. The clinical relevance of induced hypotension in orthognathic surgery must be considered to be doubtful. A mean reduction of less than 150 ml will be of limited value at the low levels of blood loss reported.
Anaesthesia, 2001
We report the first clinical application of a new anaesthetic agent-saving device. The principles... more We report the first clinical application of a new anaesthetic agent-saving device. The principles of a heat-moisture exchanger have been further developed to create a device that reduces inhalational agent consumption. Sixteen patients were randomly allocated to receive isoflurane through either a vaporiser or through the agent-saving device. A coaxial Mapleson D system (Bain) was used in both groups. A standard ventilatory setting was used, aiming for normocapnia. Mean (SD) isoflurane consumption was 24.5 (2.8) ml x MAC-hour(-1) with the vaporiser, compared with 15.2 (3.0) ml x MAC-hour(-1) with the new device (p < 0.05). This corresponded to a 40% saving in the consumption of isoflurane. The amount of isoflurane that was scavenged to the atmosphere was reduced by an average of 55%.
The American Journal of Emergency Medicine, 2008
This thesis investigated whether outcome after in-hospital cardiac arrest patients could be impr... more This thesis investigated whether outcome after in-hospital cardiac arrest patients could be improved by a cardiopulmonary resuscitation (CPR) educational intervention focusing on all hospital healthcare professionals. Annually in Sweden, approximately 3000 in-hospital patients suffer a cardiac arrest in which CPR is attempted, and which 900 will survive. The thesis is based on five papers: Paper I was a methodological study concluding in a reliable multiple choice questionnaire (MCQ) aimed at measuring CPR knowledge. Paper II was an intervention study. The intervention consisted of educating 3144 healthcare professionals in CPR. The MCQ from Paper I was answered by the healthcare professionals both before (82% response rate) and after (98% response rate) education. Theoretical knowledge improved in all the different groups of healthcare professionals after the intervention. Paper III was an observational laboratory study investigating the practical CPR skills of 74 healthcare professionals’. Willingness to use an automated external defibrillator (AED) improved generally after education, and there were no major differences in CPR skills between the different healthcare professions. Paper IV investigated, by use of a questionnaire, the attitudes to CPR of 2152 healthcare professionals (82% response rate). A majority of healthcare professionals reported a positive attitude to resuscitation. Paper V was a register study of patients suffering from cardiac arrest. The intervention tended not to reduce the delay to start of treatment or to increase overall survival. However, our results suggested indirect signs of an improved cerebral function among survivors. In conclusion, CPR education and the introduction of AEDs in-hospital – improved healthcare professionals knowledge, skills, and attitudes – did not improve patients’ survival to hospital discharge, but the functional status among survivors improved.
Anesthesiology, Mar 11, 2024
BJA: British Journal of Anaesthesia, Jun 1, 1996
Anesthesia & Analgesia, 2000
Low incidence of side effects after spinal anesthesia with heavy lignocaine through a Quincke needle
British Journal of Anaesthesia, 2003
Molecular Brain, 2013
Background Opioids are associated with wide inter-individual variability in the analgesic respons... more Background Opioids are associated with wide inter-individual variability in the analgesic response and a narrow therapeutic index. This may be partly explained by the presence of single nucleotide polymorphisms (SNPs) in genes encoding molecular entities involved in opioid metabolism and receptor activation. This paper describes the investigation of SNPs in three genes that have a functional impact on the opioid response: OPRM1, which codes for the μ-opioid receptor; ABCB1 for the ATP-binding cassette B1 transporter enzyme; and the calcium channel complex subunit CACNA2D2. The genotyping was combined with an analysis of plasma levels of the opioid peptide β-endorphin in 80 well-defined patients with chronic low back pain scheduled for spinal fusion surgery, and with differential sensitivity to the opioid analgesic remifentanil. This patient group was compared with 56 healthy controls. Results The plasma β-endorphin levels were significantly higher in controls than in pain patients. ...
Journal of Oral and Maxillofacial Surgery, 1998
Journal of Internal Medicine, 2013
In a review based on estimations and assumptions, to report the estimated number of survivors aft... more In a review based on estimations and assumptions, to report the estimated number of survivors after out-of-hospital cardiac arrest (OHCA) in whom cardiopulmonary resuscitation (CPR) was started and to speculate about possible future improvements in Sweden. An observational study. All ambulance organisations in Sweden. Patients included in the Swedish Cardiac Arrest Registry who suffered an OHCA between January 1, 2008 and December 31, 2010. Approximately 80% of OHCA cases in Sweden in which CPR was started are included. None In 11 005 patients, the 1-month survival rate was 9.4%. There are approximately 5000 OHCA cases annually in which CPR is started and 30-day survival is achieved in up to 500 patients yearly (6 per 100 000 inhabitants). Based on findings on survival in relation to the time to calling for the Emergency Medical Service (EMS) and the start of CPR and defibrillation, it was estimated that, if the delay from collapse to (i) calling EMS, (ii) the start of CPR, and (iii) the time to defibrillation were reduced to <2 min, <2 min, and <8 min, respectively, 300-400 additional lives could be saved. Based on findings relating to the delay to calling for the EMS and the start of CPR and defibrillation, we speculate that 300-400 additional OHCA patients yearly (4 per 100 000 inhabitants) could be saved in Sweden.
European Journal of Pain, 2006
European Journal of Anaesthesiology, 1997
... PET scanning What can it Tell us about Anaesthesia? Per Hartvig, Jesper Andersson, Arne Wes... more ... PET scanning What can it Tell us about Anaesthesia? Per Hartvig, Jesper Andersson, Arne Wessén, Mats Enlund, Lars Wiklund, Sven Valind and Bengt Långström Copyright Year:1998 ISBN: 978-1-84755-096-5 DOI:10.1039 ...
British Journal of Anaesthesia, 2003
Upsala Journal of Medical Sciences, 1996
European Journal of Anaesthesiology, 1997
Anesthesiology, 2003
Background The use of 100% oxygen during induction of anesthesia may produce atelectasis. The aut... more Background The use of 100% oxygen during induction of anesthesia may produce atelectasis. The authors investigated how different oxygen concentrations affect the formation of atelectasis and the fall in arterial oxygen saturation during apnea. Methods Thirty-six healthy, nonsmoking women were randomized to breathe 100, 80, or 60% oxygen for 5 min during the induction of general anesthesia. Ventilation was then withheld until the oxygen saturation, assessed by pulse oximetry, decreased to 90%. Atelectasis formation was studied with computed tomography. Results Atelectasis in a transverse scan near the diaphragm after induction of anesthesia and apnea was 9.8 +/- 5.2 cm2 (5.6 +/- 3.4% of the total lung area; mean +/- SD), 1.3 +/- 1.2 cm2 (0.6 +/- 0.7%), and 0.3 +/- 0.3 cm2 (0.2 +/- 0.2%) in the groups breathing 100, 80, and 60% oxygen, respectively (P < 0.01). The corresponding times to reach 90% oxygen saturation were 411 +/- 84, 303 +/- 59, and 213 +/- 69 s, respectively (P < ...
Anesthesia & Analgesia, 2006
To the Editor:Drs. Eger and Sonner (1) recently raised the question: is recall more likely during... more To the Editor:Drs. Eger and Sonner (1) recently raised the question: is recall more likely during IV versus inhaled anesthesia? There is no proper answer, but some findings indicate that the answer is no, as using the most (only) used diagnostic instrument for awareness detection, the structured int
The need for induced hypotension in orthognathic surgery was evaluated. Blood loss, duration of o... more The need for induced hypotension in orthognathic surgery was evaluated. Blood loss, duration of operation, quality of the surgical field, and surgical result were measured in 36 patients, assigned to either hypotension (mean arterial pressure, MAP, 50-64 mmHg) or normotension (MAP > or = 65 mmHg). Hypotension was achieved by increasing the amount of isoflurane given. The hypotensive group had significantly less bleeding over time (mean 0.9 ml/minute, 95% confidence interval (CI) of mean 0.6 to 1.2, compared with 1.8, 95% CI 1.3 to 2.4, p = 0.005). The corresponding difference in total blood loss did not differ significantly between the groups (mean 186 ml, 95% CI 98 to 275, compared with 304, 95% CI 210 to 399). No patient required transfusion of red cells. Neither the duration of surgery, nor the quality of the surgical field, nor the final result were significantly influenced by hypotension. The clinical relevance of induced hypotension in orthognathic surgery must be considered to be doubtful. A mean reduction of less than 150 ml will be of limited value at the low levels of blood loss reported.
Anaesthesia, 2001
We report the first clinical application of a new anaesthetic agent-saving device. The principles... more We report the first clinical application of a new anaesthetic agent-saving device. The principles of a heat-moisture exchanger have been further developed to create a device that reduces inhalational agent consumption. Sixteen patients were randomly allocated to receive isoflurane through either a vaporiser or through the agent-saving device. A coaxial Mapleson D system (Bain) was used in both groups. A standard ventilatory setting was used, aiming for normocapnia. Mean (SD) isoflurane consumption was 24.5 (2.8) ml x MAC-hour(-1) with the vaporiser, compared with 15.2 (3.0) ml x MAC-hour(-1) with the new device (p < 0.05). This corresponded to a 40% saving in the consumption of isoflurane. The amount of isoflurane that was scavenged to the atmosphere was reduced by an average of 55%.
The American Journal of Emergency Medicine, 2008
This thesis investigated whether outcome after in-hospital cardiac arrest patients could be impr... more This thesis investigated whether outcome after in-hospital cardiac arrest patients could be improved by a cardiopulmonary resuscitation (CPR) educational intervention focusing on all hospital healthcare professionals. Annually in Sweden, approximately 3000 in-hospital patients suffer a cardiac arrest in which CPR is attempted, and which 900 will survive. The thesis is based on five papers: Paper I was a methodological study concluding in a reliable multiple choice questionnaire (MCQ) aimed at measuring CPR knowledge. Paper II was an intervention study. The intervention consisted of educating 3144 healthcare professionals in CPR. The MCQ from Paper I was answered by the healthcare professionals both before (82% response rate) and after (98% response rate) education. Theoretical knowledge improved in all the different groups of healthcare professionals after the intervention. Paper III was an observational laboratory study investigating the practical CPR skills of 74 healthcare professionals’. Willingness to use an automated external defibrillator (AED) improved generally after education, and there were no major differences in CPR skills between the different healthcare professions. Paper IV investigated, by use of a questionnaire, the attitudes to CPR of 2152 healthcare professionals (82% response rate). A majority of healthcare professionals reported a positive attitude to resuscitation. Paper V was a register study of patients suffering from cardiac arrest. The intervention tended not to reduce the delay to start of treatment or to increase overall survival. However, our results suggested indirect signs of an improved cerebral function among survivors. In conclusion, CPR education and the introduction of AEDs in-hospital – improved healthcare professionals knowledge, skills, and attitudes – did not improve patients’ survival to hospital discharge, but the functional status among survivors improved.