European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
Duration of apnoea with two different intubating doses of remifentanil.
We have studied the apnoea time after induction with two successful drug intubating regimes, both containing remifentanil. Group 1 (n = 20); propofol 2 mg kg-1 and remifentanil 2 micrograms kg-1 and group 2 (n = 20); propofol 2 mg kg-1, remifentanil 1 microgram kg-1 and lignocaine 1 mg kg-1. Intubation was possible in all 40 patients, and regarded as acceptable in 90% and 85% of patients, respectively. ⋯ Similarly, there was a decrease in arterial pressure after induction in both groups (P < 0.05), but this was not deemed to be clinically significant. Only two patients in each group required ephedrine 6 mg before arterial pressure was restored to within 25% of the base-line. Intubating conditions were similar in both groups, but group 2 provided a significantly shorter apnoea time.
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Randomized Controlled Trial Comparative Study Clinical Trial
Remifentanil vs. fentanyl during interventional rigid bronchoscopy under general anaesthesia and spontaneous assisted ventilation.
The treatment of tracheo-bronchial diseases with rigid bronchoscopy requires general anaesthesia without tracheal intubation. Spontaneous assisted ventilation is a safe modality of ventilation. In this study the use of remifentanil and fentanyl is compared during rigid bronchoscopy with spontaneous assisted ventilation. ⋯ In conclusion, the use of remifentanil during rigid bronchoscopy under general anaesthesia with spontaneous assisted ventilation is safe and assures good operating conditions. Moreover, remifentanil permits a more rapid recovery than fentanyl. The dose of remifentanil is higher than previously described for spontaneously breathing patients.
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Randomized Controlled Trial Clinical Trial
An assessment of prochlorperazine buccal for the prevention of nausea and vomiting during intravenous patient-controlled analgesia with morphine following abdominal hysterectomy.
The effectiveness of prochlorperazine buccal as an anti-emetic for the prevention of post-operative nausea and vomiting in patients using intravenous patient-controlled analgesia with morphine following abdominal hysterectomy has been assessed in a randomized, double-blind, placebo-controlled study. Forty-nine female patients participated with 26 allocated to the prochlorperazine buccal group and the remainder to the placebo group. Each received either placebo or prochlorperazine buccal 6 mg, in each case by the buccal route, 1 h prior to anaesthesia with further doses at 6, 18, 30 and 42 h, respectively. ⋯ Intravenous droperidol is the current gold standard prophylactic anti-emetic in post-operative nausea and vomiting associated with intravenous patient controlled analgesia with morphine usage. This study has demonstrated a peri-operative prochlorperazine buccal regimen to be effective in post-operative nausea and vomiting prophylaxis in the use of intravenous patient controlled analgesia with morphine. Prochlorperazine buccal should be considered as an effective, inexpensive option for the prevention of post-operative nausea and vomiting in post-operative intravenous patient controlled analgesia with morphine administration.
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Randomized Controlled Trial Comparative Study Clinical Trial
Movement response to skin incision: analgesia vs. bispectral index and 95% spectral edge frequency.
We studied the movement response to skin incision in 68 adult (males/females) ASA I-II patients receiving propofol +/- fentanyl intravenous anaesthesia using the bispectral index and 95% spectral edge frequency monitoring with an A-1050 EEG monitor. Following Ethics Committee approval, patients were randomly assigned to one of the following four treatments: Group P (n = 17): propofol infusion, 1 mg kg-1 min-1 intravenous for 2 min, followed by propofol infusion, 200 micrograms kg-1 min-1, until skin incision; Group PF1 (n = 17): fentanyl bolus, 1 microgram kg-1 intravenous + propofol infusion as in Group P; Group PF2 (n = 17): fentanyl bolus, 2 micrograms kg-1 intravenous + propofol infusion as in Group P; and Group PF3 (n = 17): fentanyl bolus, 3 micrograms kg-1 intravenous + propofol infusion as in Group P. The bispectral index and 95% spectral edge frequency were monitored continuously and recorded prior to induction of anaesthesia (base-line) and at skin incision. ⋯ However, only bispectral index values were significantly lower in the nonmovement as compared with the movement (M) category (32.6 +/- 8.9 vs. 37.4 +/- 10.3; P = 0.04). Though deeper levels of hypnosis to lower bispectral index and 95% spectral edge frequency values may be effective in preventing the movement response to skin incision, provision of adequate analgesia rather than lower bispectral index and 95% spectral edge frequency (clinical maintenance) values may be more reliable for preventing the response to skin incision as bispectral index and 95% spectral edge frequency measure the hypnotic component of the anaesthetic effect. Lower bispectral index values may be more discriminatory as compared with 95% spectral edge frequency values for preventing the movement response to skin-incision.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects on vocal function and incidence of laryngeal disorder when using a laryngeal mask airway in comparison with an endotracheal tube.
A study of 56 patients was undertaken to determine whether there is a difference in the effect of the laryngeal mask airway and the endotracheal tube on the vocal tract after short-duration anaesthesia. All the patients were interviewed pre- and post-operatively. In 43 patients, it was possible to assess the larynx using videoendoscopy and videostrobolaryngoscopy both pre- and post-operatively. ⋯ The videostrobolaryngoscopy demonstrated minor lesions of the vocal tract in six patients in the ETT group and in one patient in the LMA group. Of the 12 voice variables evaluated, there was no significant difference in any parameter between the two groups. Both groups had a higher fundamental frequency post-operatively.