European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Is an alkalinized lignocaine solution a better topical anaesthetic for intratracheal application?
Topical anaesthesia of the trachea is used to avoid coughing during emergence from anaesthesia. This study was designed to compare the effects of an alkalinized lignocaine and plain lignocaine solution given intratracheally. After institutional approval and written informed consent, 30 patients were randomized into three groups and received in a double-blind fashion: lignocaine, alkalinized lignocaine and normal saline for control. ⋯ Noradrenaline levels were significantly diminished in the lignocaine groups (P < 0.05). Plain and alkalinized lignocaine solutions for topical anaesthesia significantly improved tolerance to the tracheal tube during emergence from anaesthesia. Plain and alkalinized lignocaine given directly before intubation reduced the sympathomimetic stress response resulting in a lower noradrenaline concentration and a reduced heart rate.
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Randomized Controlled Trial Clinical Trial
The influence of timing of ketorolac administration on post-operative analgesic requirements following total abdominal hysterectomy.
One hundred and thirty-seven patients were studied to assess whether the timing of a dose of ketorolac affected cumulative morphine requirements during the first 12 post-operative hours. Pain, sedation and nausea scores, respiratory rate and degree of operative blood loss were also recorded. Thirty-six patients (group A) were given placebo injections pre- and intra-operatively. ⋯ Thus, the timing of ketorolac administration made no difference to overall morphine consumption. Pain, nausea, sedation and respiratory rate scores were similar in all four groups. There was a significantly greater blood loss in patients receiving ketorolac (groups B, C and D) compared with those receiving placebo alone (group A).
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Randomized Controlled Trial Clinical Trial
Analgesic effect of intra-articular bupivacaine or diamorphine after arthroscopic surgery of the knee joint in day-case patients.
A prospective, randomized, double-blind, controlled study was conducted to assess the efficacy of intra-articular bupivacaine and diamorphine. Ninety-six day-case patients were allocated randomly to receive intra-articular injections of either 20 mL 0.9% saline (control, n = 35), 20 mL 0.5% plain bupivacaine (n = 31), or 20 mL 0.9% saline with 5 mg diamorphine (n = 30) prior to tourniquet release. ⋯ Intra-articular analgesics conferred a noticeable improvement in patient comfort. First, the quantity of supplementary analgesia required prior to discharge was significantly reduced (P = 0.016); second, patients reported a less disturbed night's sleep (P = 0.034).
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Randomized Controlled Trial Clinical Trial
Mivacurium or vecuronium for muscular relaxation in day-case surgery.
Anaesthetic agents for day-case surgery ideally should have a short duration of action. This study was designed to compare the efficacy and safety of mivacurium and vecuronium for healthy adults undergoing dental day-case surgery. Thirty fit healthy adult patients (ASA I or II) randomly received either mivacurium 0.15 mg kg-1 (n = 15) or vecuronium 0.1 mg kg-1 (n = 15). ⋯ One patient in the mivacurium group had a low plasma cholinesterase concentration (0.43 ku L-1); recovery times however, fell within the 95% confidence intervals (CI) for the group. There was no correlation between cholinesterase levels and recovery time. Mivacurium may be the more appropriate agent for dental day-case surgery because it has a shorter duration of action and does not generally require antagonism with an anticholinesterase.
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Randomized Controlled Trial Comparative Study Clinical Trial
Total intravenous anaesthesia using propofol, gamma-hydroxybutyrate or midazolam in combination with sufentanil for patients undergoing coronary artery bypass surgery.
Total intravenous anaesthesia (TIVA) using propofol, gamma-hydroxybutyrate (GHB) or midazolam in combination with sufentanil was investigated in 45 patients undergoing coronary artery bypass grafting (CABG). Anaesthesia was induced with sufentanil, etomidate and pancuronium. After endotracheal intubation, anaesthesia was continued with sufentanil (2 micrograms kg-1 h-1) for all patients. ⋯ No electrocardiographical signs of ischaemia were observed in any patient. In the case of propofol and midazolam, gamma-hydroxybutyrate showed adequate haemodynamic stability especially after induction of anaesthesia and may also be a suitable agent for total intravenous anaesthesia in patients with coronary artery disease. However, during sternotomy, supplementary administration of opioids was required.