European journal of anaesthesiology
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Letter Case Reports
Masseter spasm during induction of anaesthesia using propofol and fentanyl.
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Randomized Controlled Trial Comparative Study Clinical Trial
A double-blind study of axillary brachial plexus block by 0.75% ropivacaine or 2% mepivacaine.
Axillary brachial plexus block using 20 mL of 0.75% ropivacaine or 2% mepivacaine was compared in a prospective, randomized, double-blind study of two groups of 15 patients. The times to onset of sensory and motor block and to resolution of motor block, as well as the time to onset and degree of post-operative pain were recorded by an observer blinded to the identity of drug. ⋯ Nine patients who received ropivacaine and two patients who received mepivacaine did not require further post-operative analgesia (P < 0.05). Ropivacaine is less toxic than other long-acting local anaesthetics, and 0.75% ropivacaine may be better for brachial plexus block when fast onset is required and prolonged pain relief is useful.
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Randomized Controlled Trial Comparative Study Clinical Trial
Increased nausea and dizziness when using tramadol for post-operative patient-controlled analgesia (PCA) compared with morphine after intraoperative loading with morphine.
Thirty-eight ASA I-III patients undergoing lower abdominal operations were randomly allocated to receive either morphine (group M, patient-controlled analgesia bolus = 1 mg of morphine) or tramadol (group T, patient-controlled analgesia bolus = 10 mg of tramadol) for post-operative patient-controlled analgesia (PCA) after receiving morphine intraoperatively. There were no between-group differences in the pain, sedation or vomit scores. ⋯ There was no difference in the overall satisfaction. We conclude that the use of tramadol, compared with morphine, for post-operative PCA after intraoperative loading with morphine is associated with more nausea and dizziness, but with similar sedation, quality of analgesia and patient satisfaction.
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Randomized Controlled Trial Clinical Trial
Cardiovascular responses, arterial oxygen saturation and plasma catecholamine concentration during upper gastrointestinal endoscopy using conscious sedation with midazolam or propofol.
Hypoventilation as a consequence of deep intravenous sedation is the most frequently reported cause of cardiac arrest during upper gastrointestinal endoscopy (UGIE). Haemodynamic stress can contribute to myocardial ischaemia; therefore, this study was designed to observe prospectively the cardiorespiratory changes during UGIE using either midazolam or propofol for conscious sedation. Thirty-four patients, aged 50 years and older, ASA physical status I-III, scheduled for elective UGIE with sedation, were studied. ⋯ In addition, plasma catecholamine concentrations were determined. The results of this study are consistent with previous reports that cardiopulmonary events may occur during endoscopy, with or without sedation. Both midazolam and propofol sedation may provide some protection against haemodynamic stress in response to insertion and manipulation of the endoscope, but sedation can also contribute to the occurrence of hypoxaemia.
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Randomized Controlled Trial Clinical Trial
Post-tetanic burst count and train-of-four during recovery from vecuronium-induced intense neuromuscular block under different types of anaesthesia.
Recovery of neuromuscular blockade after vecuronium 0.2 mg kg-1 was measured by post-tetanic burst count (PTBC) and train-of-four (TOF) in 120 adult patients anaesthetized by one of four techniques: neuroleptanaesthesia or one minimum alveolar concentration of isoflurane, enflurane, or sevoflurane. Onset of recovery was taken when there was reflex movement in response to carinal stimulation. The time course of recovery measured by burst count was similar for all four types of anaesthesia. ⋯ P < 0.05]. The burst count at the onset of reflex movement was less under neuroleptanaesthesia than under isoflurane, enflurane, or sevoflurane anaesthesia (16.3 +/- 4.8, 26.7 +/- 6.7, 27.7 +/- 6.8, 28.0 +/- 8.4, P < 0.05). The ratio of first twitch to control twitch at the onset of reflex movement was the same for all four types of anaesthesia.