Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Dose-response relationships for edrophonium antagonism of mivacurium-induced neuromuscular block during N2O-enflurane-alfentanil anaesthesia.
The purpose of this study was to determine the dose-response relationships for edrophonium antagonism of mivacurium-induced neuromuscular block. Seventy-five ASA I or II adults were given mivarcurium 0.15 mg x kg(-1) followed by an infusion (7 micrograms x kg(-1) x min(-1) during alfentanil-propofol-N2O-enflurane anaesthesia. Train-of-four stimulation (TOF) was applied to the ulnar nerve every 20 sec and the response of the adductor policis was recorded (Relaxograph NMT-100, Datex, Helsinki, Finland). ⋯ Edrophonium 0.5 mg x kg(-1) was different from placebo with regard to recovery time of T1 from 25 to 75% (T25-75) (3.3 +/- 2.0 vs 6.7 +/- 2.0 min P<0.05). Only edrophonium 0.5 mg x kg(-1) provided faster recovery than placebo with regard to all three indices. It is concluded that edrophonium 0.5 + glycopyrrolate 0.005 mg x kg(-1) allow the fastest recovery from a mivacurium-induced block during enflurane-N2O anaesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Tonsillectomies and the reinforced laryngeal mask].
One hundred children were randomly allocated to receive general anaesthesia for tonsillectomy either through a performed tracheal tube or a reinforced laryngeal mask. The insertion of both devices was easy but occasionally, with the laryngeal mask, the airway became obstructed during the Boyle-Davis gag insertion. There was more coughing after intubation (ET 26%, RLM 0%, P< 0,001) and extubation (ET 34%, RLM 0%, P< 0,001), than after insertion and withdrawal of the RLM. Oxygen desaturation (ET 14%, RLM 2%, P< 0,002) and internal contamination with blood seepage (ET 30%, RLM 4%, P< 0,001) occurred less frequently than with the RLM.
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Randomized Controlled Trial Clinical Trial
Prophylaxis against the systemic hypotension induced by propofol during rapid-sequence intubation.
The objective of this study was to determine the effectiveness of two prophylactic approaches against the anticipated hypotension induced by propofol during rapid-sequence intubation. Thirty-six male or female nonpremedicated ASA class I-II patients aged 21-60 yr undergoing elective outpatient surgery were included in the study. Patients were randomly allocated to receive pre-induction ephedrine sulphate (70 micrograms x kg(-1)iv), pre-induction volume loading (12 ml x kg(-1) Ringer's lactate) or no treatment. ⋯ The intubating conditions were excellent to satisfactory in most patients and the overall incidence of adverse events during intubation was mainly due to pain during injection of propofol. The present study showed that preoperative volume loading is more efficacious than pre-induction administration of ephedrine sulphate in maintaining haemodynamic stability during rapid-sequence induction with propofol and succinylcholine. In addition, propofol in combination with succinylcholine provides excellent conditions for rapid-sequence intubation.