European journal of anaesthesiology
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Randomized Controlled Trial
Continuous infusion of butorphanol combined with intravenous morphine patient-controlled analgesia after total abdominal hysterectomy: a randomized, double-blind controlled trial.
Postoperative pain therapy is still a problem for clinicians. Continuous basal infusion of drugs combined with standard patient-controlled analgesia (PCA) is considered to be an effective means of postoperative acute pain management. This study was designed to investigate the analgesic efficacy, morphine-sparing effects and side effects of butorphanol delivered as a continuous infusion adjunct to intravenous morphine PCA after abdominal hysterectomy. ⋯ Basal infusion of butorphanol combined with intravenous morphine PCA in patients undergoing abdominal hysterectomy shows effective analgesia with sedation and fewer side effects.
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Randomized Controlled Trial
Landiolol, a new ultra-short-acting beta1-blocker, reduces anaesthetic requirement during sevoflurane/N(2)O/fentanyl anaesthesia in surgical patients.
It is known that esmolol, a short-acting beta1-blocker, reduces anaesthetic requirement. In this study, we evaluated whether a low dose of landiolol, a new ultra-short-acting beta1-blocker, can reduce the sevoflurane requirement. ⋯ The results suggest that a low dose of landiolol significantly reduces the intraoperative sevoflurane requirement during sevoflurane/N(2)O/fentanyl anaesthesia in patients undergoing hip surgery.
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Randomized Controlled Trial
Effects of spinal anaesthesia versus epidural anaesthesia for caesarean section on postoperative analgesic consumption and postoperative pain.
Regional anaesthesia is commonly used for elective caesarean section. The aim of this study was to investigate whether there is a positive effect of either spinal or epidural anaesthesia on postoperative analgesic requirements and pain relief. ⋯ In parturients undergoing elective caesarean section, postoperative use of epidural ropivacaine via patient-controlled epidural analgesia is similar after spinal and epidural anaesthesia. Spinal anaesthesia is, however, accompanied with less postoperative pain, use of additional analgesics and side-effects.
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Randomized Controlled Trial
Saving sevoflurane and hastening emergence from anaesthesia using an anaesthetic-conserving device.
This study compared an anaesthetic-conserving device (AnaConDa) and a conventional vaporizer in terms of sevoflurane consumption and emergence from anaesthesia using a total gas flow of 4 l min(-1), with a rebreathing circuit. ⋯ The AnaConDa could decrease sevoflurane consumption and hasten emergence from anaesthesia, but increasing sevoflurane concentration with AnaConDa at the start of anaesthesia might take longer than that with a conventional vaporizer.
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Randomized Controlled Trial
Randomised controlled trial of combined spinal epidural vs. spinal anaesthesia for elective caesarean section: vasopressor requirements and cardiovascular changes.
Combined spinal and epidural anaesthesia (CSEA) has previously been shown to result in a higher sensory block than equivalent single shot spinal anaesthesia (SSSA). In nonpregnant patients, hypotension was also more pronounced in the CSEA group. The aim of this randomized trial was to compare the haemodynamic stabilities of CSEA and SSSA during elective caesarean section when the same dose of anaesthetic was administered. This was studied directly by measuring the noninvasive arterial blood pressure (BP) and indirectly by the amount of ephedrine required to maintain baseline BP. Systemic vascular resistance index (SVRI) and cardiac index (CI) were also measured using thoracic impedance cardiography. ⋯ CSEA placement appears to offer no haemodynamic benefits compared with SSSA when the same dose of local anaesthetic is administered.