Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study Clinical Trial
Total intravenous anaesthesia with propofol, alfentanil, and oxygen-air: three different dosage schemes.
Three different dosage schemes of propofol infusions combined with a fixed-rate alfentanil infusion were investigated in total intravenous anaesthesia. In 30 premedicated patients, divided at random into three groups, anaesthesia was induced with propofol 2 mg.kg-1 immediately followed by an alfentanil infusion 10 micrograms.kg-1.min-1 as a loading dose which was decreased after ten minutes to a maintenance dose of 1 microgram.kg-1.min-1. Vecuronium bromide 0.1 mg.kg-1 was used as the muscle relaxant. ⋯ Awareness did not occur in any patient. The only difference between the three groups was the higher number of supplementary bolus doses of propofol and alfentanil needed in group A (P less than 0.01). In total intravenous anaesthesia propofol 3 and 4 mg.kg-1.hr-1 as a maintenance dose combined with a two-step fixed-rate alfentanil infusion provided smooth anaesthesia and uneventful rapid recovery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Rapid induction sequence with vecuronium: should we intubate after 60 or 90 seconds?
The purpose of the study was to determine intubating conditions after administration of either succinylcholine or vecuronium in a rapid induction sequence. Patients received either succinylcholine 1.5 mg.kg-1 (Groups I and II) after d-tubocurarine 0.05 mg.kg-1 four minutes earlier, or vecuronium (Groups III and IV) in an initial dose of 0.01 mg.kg-1 followed four minutes later by 0.1 mg.kg-1. In Groups I and III an apnoeic delay of one minute was allowed before intubation whereas in Groups II and IV the delay was 90 sec. ⋯ A delay of 90 sec after succinylcholine improved intubating conditions in male patients. Considering that intubating conditions obtained after 90 sec in patients given a priming sequence with vecuronium (Group IV) were not different from those obtained 60 sec after succinylcholine (Group I), the authors conclude that vecuronium is an acceptable alternative for rapid tracheal intubation. In the doses used in this study, intubating conditions 60 sec after vecuronium were unacceptable for rapid induction of anaesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of lidocaine CO2, two per cent lidocaine hydrochloride and pH adjusted lidocaine hydrochloride for caesarean section anesthesia.
Lidocaine can be prepared in a variety of ways which may affect the characteristics of neural blockade achieved. Experimental evidence is equivocal as to the clinical impact of the use of different lidocaine preparations. ⋯ A significant difference was found between the pH's of the solutions used. It is concluded that all three solutions are equally efficacious in epidural anaesthesia for Caesarean section.
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Randomized Controlled Trial Clinical Trial
Fluid through the epidural needle does not reduce complications of epidural catheter insertion.
Epidural catheter insertion may be associated with blood vessel trauma or nerve root irritation. The purpose of this study was to assess whether the injection of small amounts of fluid through the Tuohy needle prior to catheter insertion reduced the incidence of these and other minor complications. ⋯ There were no differences among the groups in the incidence of blood vessel trauma or paraesthesiae. We conclude that there is no advantage in injecting of fluid routinely into the epidural space prior to catheter insertion.