European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of a heat and moisture exchanger on carbon dioxide equilibrium during mechanical ventilation with the Bain circuit.
The introduction of a heat and moisture exchanger (HME) into the anaesthetic circuit may cause a rise in carbon dioxide (CO2) tension through an increase in dead space. We studied the effects of the Ultipor Pall BB50 filter included 'in series' in the Bain circuit on CO2 equilibrium. ⋯ Results showed that: females were always more hyperventilated than males when fresh gas flow was set at 70 ml kg-1 ideal body weight; the inclusion of the filter increased the PaCO2 in the group as a whole (the difference was statistically, but not clinically, significant); PaCO2 increased after the application of the filter only in females; the effects of the filter were completely independent of the patient's age. It is concluded that the use of the Ultipor Pall BB50 filter is a safe procedure during mechanical ventilation with the Bain breathing system and there is no need to modify ventilation.
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
Fentanyl and bupivacaine mixture for extradural blockade in orthopaedic surgery: effects on haemodynamic responses and pain related to the use of thigh tourniquet.
Analgesic and haemodynamic changes due to tourniquet application were investigated in a prospective double-blind study on orthopaedic patients submitted to extradural lumbar blockade with a bupivacaine and fentanyl mixture. The study was carried out in 161 healthy patients undergoing limb surgery with a thigh tourniquet. Patients were randomly assigned to two groups: each group received treatment with bupivacaine 0.5% containing 1:200,000 adrenaline. ⋯ A dramatic reduction in intra-operative supplemental analgesic needs was observed in the B:F 200 group. This group of patients also complained less of tourniquet pain than their counterparts, for the first 30 min of application. Our study underlines the value of fentanyl addition to bupivacaine in extradural blockade in orthopaedic surgery.