Anaesthesia and intensive care
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Anaesth Intensive Care · Apr 2001
Randomized Controlled Trial Comparative Study Clinical TrialA comparative study of three different methods of administering metaraminol during spinal anaesthesia in the elderly.
We compared three methods of administering metaraminol during spinal (subarachnoid) anaesthesia. Fifty-two elderly patients with fractured hips were studied. Blood pressure was maintained by either intramuscular (i.m.) metaraminol (0.1 mg x kg(-1)), intravenous (i.v.) boluses (0.01 mg x kg(-1)) or an infusion (0.05 mg x kg(-1) x h(-1)). ⋯ I.m. metaraminol during spinal anaesthesia has a very unpredictable effect. Infusions of metaraminol provided the best blood pressure control. Diastolic blood pressure fell significantly after spinal anaesthesia and this merits further investigation.
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Anaesth Intensive Care · Apr 2001
Randomized Controlled Trial Comparative Study Clinical TrialTotal intravenous versus inhalational anaesthesia for colonoscopy: a prospective study of clinical recovery and psychomotor function.
A randomized, prospective study was conducted on 69 patients comparing recovery after two different anaesthetic techniques for ambulatory colonoscopy. Thirty-five patients received an intravenous fentanyl (1 microg/kg), midazolam (0.05 to 0. 075 mg/kg) and propofol (10 to 20 mg boluses as required) combination. 34 patients received sevoflurane in 67% nitrous oxide. Drug administration was titrated to clinical signs. ⋯ A lower sedation score was detected at 20 minutes in the sevoflurane/nitrous oxide group. Psychomotor impairment was of a greater magnitude and more prolonged by 30 to 90 minutes in the fentanyl/midazolam/propofol group. It is concluded that a sevoflurane/nitrous oxide anaesthetic has a suitable recovery profile for ambulatory colonoscopy and results in faster recovery of cognitive function compared with a fentanyl, midazolam and propofol combination.
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Anaesth Intensive Care · Apr 2001
Randomized Controlled Trial Comparative Study Clinical TrialTramadol for postoperative shivering: a double-blind comparison with pethidine.
In most operating and recovery rooms, shivering is controlled by the use of humidifiers, warming blankets, and inhalation of humidified heated oxygen. However, pharmacological control is an effective alternate treatment modality. This randomized, double-blind trial, conducted in 30 ASA Grade 1 or 2 patients, was designed to explore the efficacy of tramadol and pethidine in the treatment of post-anaesthetic shivering. ⋯ Patients received either tramadol 1 mg/kg or pethidine 0.5 mg/kg intravenously and the grade of shivering, pulse rate, blood pressure and respiratory rate were observed every 10 minutes after injection for one hour Shivering was significantly more likely to have ceased in the tramadol group (12 of 15 versus 4 of 15 cases, P<0.05) at 10 minutes after drug administration and this control was better sustained. No patients receiving tramadol had a recurrence of shivering. It is concluded that intravenous tramadol 1 mg/kg is more effective for the treatment of postoperative shivering than pethidine 0.5 mg/kg.