Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 1989
Randomized Controlled Trial Clinical TrialChest wall rigidity during fentanyl- and midazolam-fentanyl induction: ventilatory and haemodynamic effects.
In a double-blind randomised study, we examined if pretreatment with small doses of midazolam, given before anaesthesia induction with fentanyl, influences the occurrence of fentanyl-induced thoracic rigidity (FITR). At the same time, the effect of rigidity on the cardiovascular and respiratory system was assessed. Sixteen patients undergoing coronary artery bypass surgery were divided into two groups. ⋯ The incidence of FITR was high in both groups: 63% in Group M and 75% in Group P (n.s.); however, its severity was less in Group M. The appearance of rigidity affected the cardiovascular and the respiratory system: central venous and pulmonary capillary wedge pressures showed a sharp increase in patients with FITR accompanied by CO2 retention, due to an inability to ventilate these patients adequately. We conclude that small doses of midazolam do not prevent, but may attenuate, FITR and that the appearance of rigidity causes alterations of haemodynamic and respiratory variables during induction.
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Acta Anaesthesiol Scand · Jan 1989
Randomized Controlled Trial Clinical TrialThe effect of continuous intravenous indomethacin infusion on bleeding time and postoperative pain in patients undergoing emergency surgery of the lower extremities.
Fifty-four orthopaedic patients were given either indomethacin (25-50 mg bolus plus infusion, 5-7.5 mg h-1) or only lactated Ringer solution intravenously over 20 h in a randomized and double-blind fashion. The study was started at the casualty department as soon as possible after the decision to operate was made. The patients were given a spinal block with bupivacaine, and the evaluation included postoperative analgesia and IVY bleeding times. ⋯ The mean IVY bleeding time was prolonged in the indomethacin group after 20 h of infusion (P less than 0.05). No abnormal bleeding was observed immediately postoperatively. However, at the end of the infusion there were more patients who bled through their bandages and casts in the indomethacin group (4/28 vs. 1/26).