European journal of anaesthesiology
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Randomized Controlled Trial Clinical Trial
Target-controlled propofol requirements at induction of anaesthesia: effect of remifentanil and midazolam.
Target-controlled infusions of anaesthetic agents have become increasingly available. They can involve the use of propofol in combination with an opioid or a benzodiazepine. The effect site concentration of propofol infusions has been advocated as a method of estimating drug distribution. We investigated the influence of co-induction with remifentanil and midazolam on effect site propofol requirements at induction of anaesthesia using target-controlled infusions. ⋯ We conclude that co-induction with remifentanil alone or with midazolam can be used to reduce propofol doses at induction of anaesthesia using target-controlled infusions. We believe that using effect site concentration may prove a useful tool in routine clinical practice.
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Clinical Trial
Decrease in minimum alveolar concentration of sevoflurane during anaesthesia and arthroscopy.
Although the MACtetanus (minimum alveolar concentration that prevents movement in response to electrical tetanus stimulation in 50% of patients) of isoflurane decreases during anaesthesia and surgery, it is not known whether this occurs to the same extent with other inhalational anaesthetics. We determined the MACtetanus of sevoflurane before and after surgery. ⋯ It is concluded that the MACtetanus of sevoflurane decreases during anaesthesia and surgery.
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Randomized Controlled Trial Clinical Trial
Anaesthetic and postoperative analgesic effects of spinal clonidine as an additive to prilocaine in the transurethral resection of urinary bladder tumours.
The alpha 2-adrenoceptor agonist clonidine has potent central antinociceptive properties. The study was designed to investigate the effects of the combined subarachnoid administration of clonidine and prilocaine on spinal block and postoperative analgesia for the transurethral resection of tumours in the urinary bladder. ⋯ The addition of clonidine 75 micrograms to prilocaine 75 mg for subarachnoid anaesthesia increased the duration of sensory and motor block and reduced the need for additional postoperative analgesics by providing excellent analgesia for about 8 h during recovery from transurethral resection of bladder tumours.
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Randomized Controlled Trial Comparative Study Clinical Trial
Spinal block or total intravenous anaesthesia with propofol and remifentanil for gynaecological outpatient procedures.
The aim of this prospective, randomized study was to compare the preparation and discharge times, the side-effects and patient satisfaction after gynaecological outpatient procedures performed using either spinal block or total intravenous anaesthesia with propofol and remifentanil. ⋯ Accurate titration of short-acting intravenous anaesthetic drugs such as propofol and remifentanil results in shorter preparation times and earlier home discharge after outpatient gynaecological procedures compared with spinal anaesthesia with hyperbaric bupivacaine 10 mg, with better patient acceptance and no increased costs.
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Randomized Controlled Trial Clinical Trial
Effects of sodium nitroprusside-induced controlled hypotension on pancreatic function assessed by pancreatitis-associated protein in patients undergoing radical prostatectomy.
Controlled hypotension may alter organ blood flow and tissue oxygenation. The aim of the study was to investigate whether induced hypotension using sodium nitroprusside alters pancreatic function assessed by pancreatitis-associated protein concentrations in the blood. ⋯ Controlled hypotension during surgery was associated with a small but significant increase in pancreatitis-associated protein compared with controls. The absence of concomitant elevation in lipase concentrations and a lack of clinical evidence of pancreatitis damage suggest that hypotension induces mild pancreatic stress.