European journal of anaesthesiology
-
Randomized Controlled Trial Comparative Study Clinical Trial
Epidural analgesia for labour using a continuous infusion of bupivacaine and alfentanil.
Seventy women who requested epidural pain relief in labour received a continuous epidural infusion at 8 ml h-1, which contained either 0.25% bupivacaine (n = 29), or a mixture of 0.125% bupivacaine and 0.005% alfentanil (n = 31), assigned randomly. Increments of 4 ml 0.25% bupivacaine were given on demand to prevent residual pain from uterine contractions. ⋯ One of the women receiving the mixture and eight of the women receiving bupivacaine alone had almost complete motor block. There were no differences in the mode of delivery or in the neonatal Apgar scores.
-
Randomized Controlled Trial Clinical Trial
Effects of acupuncture and transcutaneous stimulation analgesia on plasma hormone levels during and after major abdominal surgery.
The effects of acupuncture and transcutaneous electrical stimulation (TES) on plasma adrenaline (A) and noradrenaline (NA), adrenocorticotropic hormone (ACTH), beta-endorphin (beta E), anti-diuretic hormone (ADH) and hydrocortisone (cortisol) were evaluated during and, for four days after surgery in 42 male patients submitted to a standardized major abdominal operation in a comparative study of three different anaesthetic techniques. Group 1 received acupuncture and transcutaneous stimulation as the main non-pharmacological analgesic during surgery. Group 2 received moderate-dose fentanyl (initial bolus of 10 micrograms kg-1 followed by continuous infusion of 5 micrograms kg-1 h-1 for the first hour, and then 4 micrograms kg-1 h-1. ⋯ Group 3). It is concluded that acupuncture and TES have no effect on the cardiovascular response to laryngoscopy and intubation. They can replace moderate-dose fentanyl anaesthesia in major abdominal surgery at the cost of a more enhanced per-operative neuroendocrine stress response, which does not, however, influence the postoperative hormonal profiles nor the rapidity of return to pre-operative values.
-
Randomized Controlled Trial Clinical Trial
Effect of intravenous diclofenac on pain and recovery profile after day-case laparoscopy.
Diclofenac sodium, 100 mg, or saline was given intravenously after the induction of anaesthesia to 169 patients undergoing outpatient gynaecological diagnostic laparoscopy or laparoscopic sterilization by tubal ligation. Propofol was used as the main anaesthetic agent and fentanyl and paracetamol were given for post-operative pain relief. In the post-anaesthesia care unit the amount of analgesics given and the incidence of nausea and vomiting were recorded. ⋯ However, patients in the tubal ligation group needed significantly more post-operative analgesia than patients in the laparoscopy group. Diclofenac had no influence on the rapidity of recovery or home readiness in either group. It is concluded that diclofenac has no influence on home readiness, but prevents postoperative pain in patients undergoing diagnostic laparoscopies, whereas it was not a potent enough analgesic to prevent pain after laparoscopic tubal ligation.
-
Randomized Controlled Trial Clinical Trial
Central nervous system symptoms after intravenous lignocaine: dose-response during pregnancy.
There is continuing controversy over what dose of what drug should be used to identify an accidental intravascular or subarachnoid catheter placement in obstetric epidural anaesthesia. The purpose of this randomized, double-blind study was to evaluate the dose-effect relationship for the production of central nervous system (CNS) symptoms by intravenous lignocaine. ⋯ An ED95 of 1.12 mg kg-1 was calculated to produce reliable CNS symptoms when injected intravascularly. Lignocaine is an effective and reliable marker for intravenous injection in pregnant women.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Intubation with propofol: evaluation of pre-treatment with alfentanil or lignocaine.
The effect of lignocaine or alfentanil pre-treatment on conditions at orotracheal intubation following induction with propofol, but without the use of muscle relaxants, were compared in a prospective, controlled, double-blind study. Forty five healthy patients undergoing elective surgery were randomly allocated to receive either 0.9% saline (control), alfentanil 20 micrograms/kg-1, or lignocaine 1.5 mg kg-1 prior to induction with propofol 2.5 mg kg-1. ⋯ Intubation scores of 1 or 2 were obtained in 14 out of 15 patients (93%) in the alfentanil group and this was significantly better than the lignocaine group (33%) or control group (20%). No difference was detected between the scores of the latter two groups.