European journal of anaesthesiology
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Previous studies have shown existence of inconsistent data concerning the use of auditory-evoked potential (AEP) and electroencephalogram (EEG) changes to measure the depth of anaesthesia in regimens involving the use of opioids. The present studies characterize the effects of fentanyl on those responses in rats. ⋯ These excitatory effects were inconsistent with the classical concept of brain activity depression indicating a deepening of anaesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Sedation for neuroradiology revisited: comparison of three techniques for cerebral angiography.
Previous work in our department, prior to the advent of digital subtraction angiography, showed that anaesthetist-administered sedation for cerebral angiography using propofol infusion-bolus fentanyl resulted in significantly more patients with early recall than a bolus fentanyl and midazolam technique. Our present study reassessed, 10 yr after our original study, the effectiveness of sedation for neuroradiological digital subtraction cerebral angiography, using three techniques currently in use in the department. ⋯ Our results show that since the introduction of digital subtraction angiography we may have a different end-point of sedation compared to our original study, as well as a shorter angiogram time. Satisfactory anaesthetist-administered sedation can be provided for cerebral angiography by either infusion or incremental techniques. We feel that the success and safety of a sedation technique depends considerably on the skill and experience of the administrator such that these sedation techniques are only suitable for safe use by an anaesthetist.
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Perioperative hypothermia is generally regarded as undesirable, but its incidence rate in the elective procedures in our hospital and the effect of the preventative measures taken against it were unknown. An initial audit indicated that postoperative hypothermia occurred. Therefore, changes in practice were implemented to address the problem. A further audit was then undertaken to assess the impact of these measures. ⋯ We found that with simple but consistently implemented changes in practice, postoperative hypothermia in elective patients could largely be eradicated.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of clevidipine with sodium nitroprusside in the control of blood pressure after coronary artery surgery.
We set out to compare the efficacy of clevidipine and sodium nitroprusside infusions in the control of blood pressure and the haemodynamic changes they produce in hypertensive patients after operation for elective coronary bypass grafting. ⋯ There was no significant difference between clevidipine and sodium nitroprusside in their efficacy in controlling MAP. The haemodynamic changes, including tachycardia, were less pronounced with clevidipine than with sodium nitroprusside.