European journal of anaesthesiology
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Randomized Controlled Trial Clinical Trial
Analgesia for outpatient surgery: placebo versus naproxen sodium (a non-steroidal anti-inflammatory drug) given before or after surgery.
One hundred and eighty patients scheduled for day-care surgery were allocated randomly to one of three groups to receive naproxen sodium 1100 mg 1 h prior to surgery, naproxen sodium 1100 mg immediately after surgery, or placebo. The pre-surgery naproxen sodium group had significantly lower pain scores 1 h post-operatively and at discharge than the placebo group. At discharge both treatment groups were better than placebo. ⋯ A questionnaire concerning general acceptability of anaesthesia/analgesia showed similar results. Our conclusion is that naproxen is better than placebo for treatment of post-operative pain. The time of administration pre- or post-operatively is important for the immediate post-operative pain, but we found no support for the existence of 'pre-emptive analgesia'.
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Randomized Controlled Trial Comparative Study Clinical Trial
Total intravenous anaesthesia with sufentanil-midazolam for major abdominal surgery.
Haemodynamic and endocrine stress responses were compared during total intravenous anaesthesia with sufentanil and midazolam or fentanyl and midazolam in patients undergoing elective major abdominal surgery. Twenty-two ASA I and II patients were allocated randomly to receive sufentanil (induction 1.5 micrograms kg-1 plus infusion 1.5 micrograms kg-1 h-1) or fentanyl (induction 10 micrograms kg-1 plus infusion 10 micrograms kg-1 h-1) supplemented with 0.15 microgram kg-1 sufentanil or 1 microgram kg-1 fentanyl as necessary. Midazolam was infused to obtain plasma concentrations of 500-600 ng ml-1. ⋯ Cortisol, glucose and lactate concentrations increased in both groups. Bradycardia occurred in four patients with sufentanil and in three with fentanyl. There were two cases of marked thoracic rigidity with sufentanil and one with fentanyl.
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
Use of EEG spectral edge as index of equipotency in a comparison of propofol and isoflurane for maintenance of general anaesthesia.
Propofol and isoflurane were compared for haemodynamic stability and recovery time as main anaesthetic agents for maintenance in a total of 43 ASA I and II patients in uncomplicated operations lasting at least 30 min. The premedication (oral diazepam), induction (thiopentone-fentanyl-suxamethonium) and maintenance protocol (N2O-O2 2:1 litre min-1, fentanyl and vecuronium in incremental doses) were identical for all patients. In one group of 20 patients, propofol was used in continuous intravenous (i.v.) infusion (starting dose 3 mg kg-1 h-1), while in the second group of 23 patients, isoflurane was administered in a starting concentration of 1%. ⋯ The incidence of mean blood pressure deviations/case in the propofol group was less than half of those occurring in the isoflurane group (0.45 vs. 0.96 P = 0.04). The mean duration of blood pressure deviation from baseline value was 5.5 min in the propofol group vs. 16.8 min in the isoflurane group (P = 0.01). The recovery intervals were significantly shorter in the propofol group (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
Double burst stimulation with submaximal current.
The present study evaluated responses to double burst stimulation (DBS) at supramaximal and submaximal currents in 30 adult patients. Usually, DBS is applied with supramaximal stimulation, but this may be quite uncomfortable for the awake patient. Therefore, the authors investigated whether it is possible to obtain an accurate assessment of significant residual neuromuscular blockade if the stimulus current is reduced to 30 mA. ⋯ The relations between control T4/T1 ratios determined by supramaximal TOF stimulation and D2/D1 ratios determined by supramaximal DBS3.3 and submaximal DBS3.3 were Y = 0.99X + 0.08 and Y = 1.01X + 0.04, respectively, and there was no statistical difference between the two regression lines. The same relation between T4/T1 ratios and D2/D1 ratios by DBS3.2 were Y = 0.69X + 0.05 and Y = 0.72X + 0.02, respectively, and there was no significant difference. It is concluded that evaluation of the response to DBS at 30 mA has the same reliability as evaluation with supramaximal current.
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Randomized Controlled Trial Clinical Trial
Airway management in dental anaesthesia.
Ninety patients were allocated randomly to three groups for airway maintenance during paediatric outpatient dental extraction: laryngeal mask airway, nasal mask with nasopharyngeal airway, or nasal mask alone. Surgical access was better with the laryngeal mask. ⋯ No patient became hypoxic with the laryngeal mask, five patients became hypoxic with the nasal mask and two with the nasopharyngeal airway at corresponding periods, although the differences were not statistically significant. The laryngeal mask airway is recommended for paediatric outpatient dental anaesthesia.