Anesthesia and analgesia
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Anesthesia and analgesia · Jan 1988
Comparative Study Clinical Trial Controlled Clinical TrialEffect of naloxone infusion on analgesia and respiratory depression after epidural fentanyl.
The efficacy of two dosage regimens of intravenous naloxone were compared to avoid nonrespiratory side effects and respiratory depression and yet to preserve analgesia (maximum tolerance to periostial pressure over the tibia) after administration of 200 micrograms epidural fentanyl. Three groups of eight patients were studied: group 1 patients received a loading dose of 0.4 mg IV naloxone followed by naloxone infusion at a rate of 10 micrograms.kg-1.hr-1. Group II patients received a loading dose of 0.2 micrograms naloxone followed by a naloxone infusion at a rate of 5 micrograms.kg-1.hr-1. ⋯ In group III, neither periostial analgesia nor nonrespiratory side effects were affected. The baseline slopes of VE/PETCO2 were 2.34 +/- 1.01, 2.14 +/- 0.66, and 2.68 +/- 1.14 L.min-1.mm Hg-1, respectively, in groups I, II, and III. Epidural fentanyl significantly decreased the slope below baseline levels in each group: -21 +/- 16%, -22 +/- 17%, and -19 +/- 32%, respectively, in groups I, II and III.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Jan 1988
Randomized Controlled Trial Comparative Study Clinical TrialAwakening concentrations of isoflurane are not affected by analgesic doses of morphine.
A randomized, double-blind study was performed to determine how morphine 0.1 mg/kg IV, or placebo administered 80 +/- 11 (means +/- SE) minutes before the end of surgery affect recovery from isoflurane/oxygen anesthesia. End-tidal isoflurane remained constant at 1.10 +/- 0.02% (means +/- SE) in both groups intraoperatively, and no other anesthetics were given after the administration of the morphine or placebo. ⋯ At the time of eye-opening, end-tidal isoflurane concentrations did not differ between subjects receiving morphine (0.20 +/- 0.02%) and placebo (0.18 +/- 0.01%). It is concluded that the awakening concentration (MAC-awake) during recovery from isoflurane anesthesia is approximately 0.19% and is not affected by analgesic doses or morphine.
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Anesthesia and analgesia · Jan 1988
Comparative StudyNeonatal neurobehavior after epidural anesthesia for cesarean section: a comparison of bupivacaine and chloroprocaine.
Reports of whether or not bupivacaine affects neonatal neurobehavior have been contradictory. The purpose of this study was to test the hypothesis that scores on the Brazelton Neonatal Behavioral Assessment Scale (BNBAS) after epidural anesthesia with bupivacaine for cesarean section would not be different than those after chloroprocaine. Furthermore, if there were any effects, it was hypothesized that they would be related to cord blood levels of the drug. ⋯ The results indicate that infants in the bupivacaine group do significantly better than those in the chloroprocaine group in the orientation cluster of the BNBAS (F[1,49] = 22, P less than 0.001); this cluster reflects higher cortical functioning. Furthermore, there was improvement in the bupivacaine group in the regulation of state cluster with age, whereas there was no improvement in the chloroprocaine group (F[1,53] = 4.34, P less than 0.01). This study suggests that performance on the BNBAS after exposure to bupivacaine is better than that after exposure to chloroprocaine.
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Anesthesia and analgesia · Jan 1988
Recovery scores do not correlate with postoperative hypoxemia in children.
The correlation between the degree of postanesthetic recovery (PAR) in children as measured by a modified Aldrete scoring system and oxygen saturation (SaO2) was studied. Eighty-one ASA PS I unpremedicated infants and children were studied. Oxygen saturation and PAR scores were recorded on arrival in the recovery room, then at 5-minute-intervals. ⋯ It is concluded that children recovering from anesthesia can become hypoxemic in the recovery room. The degree of wakefulness as measured by a PAR score cannot be used to establish an end point for oxygen supplementation. Oxygen supplementation and/or SaO2 monitoring are recommended in all children recovering from anesthesia.
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Anesthesia and analgesia · Jan 1988
Comparative StudyIn vitro effect of fresh frozen plasma on the activated coagulation time in patients undergoing cardiopulmonary bypass.
The in vitro effect of fresh frozen plasma (FFP) on the whole blood activated coagulation time (ACT) was examined in 18 patients undergoing cardiopulmonary bypass (CPB) during coronary artery bypass graft surgery. The addition of FFP to whole blood in vitro, after systemic heparinization, significantly prolonged the ACT from 451 +/- 21 seconds (mean +/- SE) to 572 +/- 41 seconds (P less than 0.05). ⋯ The addition of FFP to whole blood in three of the six patients who exhibited heparin resistance (ACT less than 400 seconds after administration of 350 unit/kg heparin) did not prolong the ACT to greater than 400 seconds. These observations suggest that infusion of FFP will further prolong the ACT after heparin administration in most patients including some with initial heparin resistance.