European journal of anaesthesiology
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Randomized Controlled Trial Clinical Trial
Nitrous oxide reduces the cost of intravenous anaesthesia.
One hundred and one women (ASA grades I and II) were anaesthetized for routine gynaecological surgery using an intravenous (i.v.) anaesthetic technique combining propofol and alfentanil. The patients were allocated randomly into groups. ⋯ There was no significant difference in the incidence of postoperative complications between the two groups. We suggest that nitrous oxide may be used to reduce the cost of total i.v. anesthesia with propofol and alfentanil without causing any increase in post-operative morbidity in patients undergoing routine gynaecological surgery.
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Comparative Study
Comparative use of muscle relaxants and their reversal in three European countries: a survey in France, Germany and Great Britain.
A survey was conducted among British, French and German anaesthetists to evaluate possible national differences in the peri-operative use of muscle relaxants and their reversal agents. The same non-depolarizing relaxants are used in all three countries, with the exception of d-tubocurarine, which is only available in Great Britain, and alcuronium which is mainly used in Germany. The French anaesthetists seem to use significantly less succinylcholine than their peers in Great Britain or Germany for both elective and emergency intubation. ⋯ Dose regimes for neostigmine vary largely, with German anaesthetists administering the lowest, and British anaesthetists administering the highest doses. Side effects of reversal agents are reported by colleagues from all three countries in too high a percentage to justify uncritical administration of these drugs. In Germany there seems to be a noteworthy lack of recovery facilities.
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General anaesthesia for a patient with tuberous sclerosis was complicated by epilepsy. The choice of drugs was related to control of his fits and intercurrent therapy. Thiopentone, vecuronium, and nitrous oxide with isoflurane were satisfactory.
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Abnormalities of platelet haemostasis pose increased risk to patients undergoing anaesthesia and surgery. We have investigated the effect of propofol on platelet aggregation in 12 patients undergoing upper and lower abdominal surgery. ⋯ Platelet aggregation measurements were made for adenosine diphosphate (ADP), collagen and adrenaline. The results show that propofol does not affect platelet aggregation in the concentrations used.