European journal of anaesthesiology
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Randomized Controlled Trial Clinical Trial
Administration of vecuronium, atracurium and pancuronium in divided doses: effect on onset and duration of action.
The time to onset of neuromuscular block (as assessed by single twitch stimulation at 0.1 Hz) and the duration to 25% recovery of twitch height were measured after administration of vecuronium 0.1 mg kg-1, atracurium 0.5 mg kg-1 or pancuronium 0.1 mg kg-1, administered either as a single bolus or in divided doses, 10% being administered 4 min prior to the remaining 90%. The patients were anaesthetized with thiopentone, nitrous oxide in oxygen and i.v. fentanyl. There was no significant difference between the single- and divided-dose groups, either in the onset times (2.8 and 2.9 min for vecuronium, 2.7 and 2.4 min for atracurium and 3.3 min each for pancuronium for single- and divided-dose groups, respectively) or the duration to 25% recovery of twitch height (35 and 29 min for vecuronium, 45 and 39 min for atracurium and 87 and 93 min for pancuronium for single- and divided-dose groups, respectively).
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
Nausea and vomiting after general anaesthesia with isoflurane, enflurane or fentanyl in combination with nitrous oxide and oxygen.
One-hundred and eighty patients undergoing elective abdominal hysterectomy were anaesthetized in random order with isoflurane, enflurane or fentanyl in combination with nitrous oxide and oxygen. Incidence and severity of emetic sequelae (none, nausea, retching or vomiting) were studied during the first 24 h after the operation. ⋯ There was no difference between the groups in the overall incidence of emetic sequelae during the time period of 2-24 h post-operatively (isoflurane 65%, enflurane 77% and fentanyl 77%). Significantly (P less than 0.02) more patients had emetic sequelae if they had experienced nausea or had vomited after previous anaesthetics.
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Randomized Controlled Trial Clinical Trial
Epidural sufentanil for post-operative pain relief: effects of adrenaline.
The analgesic, respiratory and haemodynamic effects of epidural sufentanil 75 micrograms (Group 1) or sufentanil 75 micrograms with adrenaline 75 micrograms (Group 2) were studied in 20 patients following abdominal surgery in a double-blind randomized trial. Pain relief, assessed on a linear analogue scale, sedation, heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR) and arterial carbon dioxide tension (PaCO2) were recorded before, and for 12 h after, injection. Good post-operative pain relief was obtained after 4 min in Group 1 and 6 min in Group 2. ⋯ The patients in Group 1 showed more marked sedation 1 h after injection. Changes of HR and MAP were similar in both treatment groups. Side-effects were observed more frequently in Group 2, although the differences were not significant.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
Accelerated onset of non-depolarizing neuromuscular blocking drugs: pancuronium, atracurium and vecuronium. A comparison with succinylcholine.
The time of onset and degree of neuromuscular blockade (NMB) in 80 anaesthetized patients, following either a single bolus injection of pancuronium 0.95 mg kg-1, atracurium 0.53 mg kg-1 or vecuronium 0.07 mg kg-1, or divided doses of pancuronium 0.15 mg kg-1, atracurium 0.07 mg kg-1 or vecuronium 0.01 mg kg-1 administered 3 min or 5 min before the second dose of pancuronium 0.08 mg kg-1, atracurium 0.46 mg kg-1 or vecuronium 0.06 mg kg-1, were determined and compared to the same parameters measured following succinylcholine administration (1 mg kg-1). The time to maximum NMB (100%) following the administration of succinylcholine was 58.1 +/- 5.3 s, whereas the time to maximum NMB (100%) following a single bolus injection of either pancuronium, atracurium or vecuronium was 130.6 +/- 22.2, 93.0 +/- 6.4, 127.5 +/- 13.0 s, respectively. ⋯ However, when the two doses of drug were separated by 5 min, only small, non-significant further decreases occurred in the time required to achieve maximum blockade. Although the time to maximum NMB following divided doses of pancuronium, atracurium or vecuronium is significantly longer than that for succinylcholine, divided dosing significantly decreases the time required to reach maximal NMB.
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Randomized Controlled Trial Comparative Study Clinical Trial
Antagonism of pancuronium and tubocurarine blocks by edrophonium or neostigmine: a comparative study.
Edrophonium 0.5 and neostigmine 0.05 mg kg-1 were compared as antagonists of pancuronium and tubocurarine-induced neuromuscular blocks, at varying degrees of recovery, in groups of 20 patients each. Adequate antagonism was defined as attaining a sustained train-of-four (TOF) ratio of 0.7 or more. Administration of edrophonium was associated with a more rapid onset of action (17 s with both relaxants with edrophonium, and 31 s and 29 s with neostigmine with pancuronium and tubocurarine, respectively), and a shorter time to attain a TOF ratio of 0.7 (74 s and 48 s with edrophonium and 230 s and 293 s with neostigmine for pancuronium and tubocurarine blocks, respectively). ⋯ Two separate groups of 10 patients each with relatively deeper pancuronium or tubocurarine blocks (three or less responses to TOF stimulation) were given edrophonium in a dose of 1.0 mg kg-1. However, adequate antagonism even with this dose of edrophonium was attained in only two out of 10 patients given pancuronium and in five out of 10 patients given tubocurarine. It is concluded that edrophonium is unreliable for antagonism of relatively deep blocks by pancuronium or tubocurarine and that neostigmine is the preferred and more reliable antagonist.