European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Minimal flow sevoflurane and isoflurane anaesthesia and impact on renal function.
Compound A generation and accumulation in sevoflurane anaesthesia is dependent on fresh gas flow. We investigated the extent of generation of compound A. ⋯ Compound A concentrations using 0.5 L min-1 fresh gas flow and a heated absorber were higher than previously published values using an inflow of 1 L min-1. Compound A exposure was similar to other clinical studies which did not show changes in renal and hepatic function.
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Randomized Controlled Trial Clinical Trial
Gum elastic bougie, capnography and apnoeic oxygenation.
This study assessed the accuracy of using capnography with a modified, hollow gum elastic bougie in predicting tracheal intubation, and its effectiveness as a method of apnoeic oxygenation. ⋯ The modification of the gum elastic bougie allows a more objective assessment of correct placement than the previous tactile method. The current design of bougie is unsuitable but can be modified.
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Randomized Controlled Trial Clinical Trial
Pre-emptive efficacy of epidural fentanyl in elective abdominal surgery.
This study determines whether epidural fentanyl given before incision decreases the requirements for opioid analgesia postoperatively, compared with the same dose of epidural fentanyl given after the surgery. ⋯ This study showed that the dose of fentanyl administered epidurally prior to surgical incision did not produce any clinically useful pre-emptive analgesic effect.
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Randomized Controlled Trial Clinical Trial
Haemodynamic responses to the intubating laryngeal mask and timing of removal.
We determined (a) the haemodynamic responses to intubating laryngeal mask (ILM) airway insertion/intubation and removal in anaesthetized patients, and (b) whether the timing of ILM removal influences these responses. One-hundred and twenty patients without cardiovascular disease were studied. ILM airway insertion/intubation was 5 min after induction with propofol 2 mg kg(-1) and maintenance of anaesthesia with sevoflurane 2% in oxygen 33% and nitrous oxide. ⋯ Early removal or multiple intubation attempts did not exceed baseline haemodynamic values. We conclude that ILM insertion/intubation and removal in anaesthetized patients produces little or no haemodynamic response, even if multiple intubation attempts are required. The timing of removal exerts a small, but clinically unimportant influence on these responses.
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Randomized Controlled Trial Comparative Study Clinical Trial
Epidural fentanyl-bupivacaine compared with clonidine-bupivacaine for analgesia in labour.
Alpha-adrenergic agonists produce pain relief through an opioid independent mechanism and may be alternatives to opioids for combination with local anaesthetics for analgesia during labour. We studied 41 pregnant women. Epidural block was performed with 75 microg clonidine (n = 20) or 50 microg fentanyl (n = 21) combined with 0.125% bupivacaine (10 mL). ⋯ Analgesia lasted longer in the bupivacaine-clonidine group (139.4 +/- 31 min) compared with the bupivacaine-fentanyl group (127.9 +/- 48 min) (P = 0.42). Additional analgesic requirement was more often in the fentanyl-bupivacaine group and total bupivacaine requirement was less in the clonidine-bupivacaine group (22.5 +/- 12.5 mg vs. 30.9 +/- 12.8 mg) (P = 0.04). This small study confirms that this combination of bupivacaine and clonidine provides satisfactory analgesia for first-stage labour, and of longer duration than bupivacaine-fentanyl.