Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 1995
Randomized Controlled Trial Clinical TrialFentanyl attenuates cardiovascular responses to tracheal extubation.
We carried out a controlled, randomized, double-blind study to examine the effects of intravenous fentanyl (1 or 2 micrograms kg-1) on hemodynamic changes during tracheal extubation and emergence from anesthesia in 60 ASA physical status I or II patients undergoing elective gynecological surgery. Anesthesia was maintained with 0.5%-1.5% isoflurane and 60% nitrous oxide (N2O) in oxygen. Muscle relaxation was achieved with vecuronium. ⋯ Postoperative somnolence and respiratory depression were not observed in any patients in any of the three groups. We concluded that a bolus dose of intravenous fentanyl 2 micrograms kg-1 given at the time of peritoneal closure was of value in attenuating the cardiovascular changes associated with tracheal extubation and emergence from anesthesia, and that this treatment did not prolong the recovery. However, further studies are required to assess this technique in patients with cardiovascular or cerebrovascular diseases.
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Acta Anaesthesiol Scand · Jan 1995
Randomized Controlled Trial Clinical TrialFailure to influence hypotension during spinal anaesthesia with a limb tourniquet.
Fourty patients undergoing total hip replacement under spinal anaesthesia were allocated randomly to have a thigh tourniquet inflated after exanguination of the leg not being operated on or to act as controls. Significant hypotension (systolic arterial pressure < 70 mm Hg) was treated with i.v. ephedrine in 6 mg boluses. There was no significant difference between the two groups with respect to systolic blood pressure or requirement of ephedrine, during the hour that the tourniquet was applied or the period immediately after the removal of the tourniquet.
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Acta Anaesthesiol Scand · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialComparison of parenteral diclofenac and ketoprofen for postoperative pain relief after maxillofacial surgery.
Non-steroidal anti-inflammatory drugs (NSAID) effectively reduce the need for opioid analgesia after various types of surgery. The efficacy of diclofenac and ketoprofen to relieve pain after maxillofacial surgery was compared in the present study. In a randomized and double-blind fashion, 90 ASA I-II patients (16-60 yrs) were studied, divided into three groups: Thirty patients received 1.0 mg.kg-1 diclofenac i.v. after general anaesthesia induction, before surgical incision, and four hours later the same dose was given i.m. ⋯ Overall, there was a lower need for i.v. oxycodone during the 24-hour period in the diclofenac group (269 doses) than in the ketoprofen group and in the saline group (388 doses, each) (P < 0.01). The significantly lower number of oxycodone administrations in the diclofenac group was a result of a distinguishable difference, particularly during the first four hours after surgery. There was no statistically significant difference in the incidence of side effects of the analgesic therapy between the three groups.
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Acta Anaesthesiol Scand · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialWound infiltration with ropivacaine and bupivacaine for pain after inguinal herniotomy.
In a double-blind, randomized study, 32 patients scheduled for elective inguinal herniotomy under general anaesthesia received subcutaneous infiltration with 40 ml ropivacaine 2.5 mg/ml or bupivacaine. Postoperative pain intensity was assessed repeatedly for 24 hours at rest, during cough and movement on a visual analogue scale (VAS) and by means of pressure algometry. ⋯ The demand for analgesics was similar in the two groups. We conclude that incisional ropivacaine is as effective as bupivacaine in the management of post-herniotomy pain.
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Acta Anaesthesiol Scand · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialControl of post anaesthetic shivering with nefopam hydrochloride in mildly hypothermic patients after neurosurgery.
Postoperative shivering may be prevented by maintaining normothermia intraoperatively or it may be treated using specific drugs. The aim of this study was to compare the efficacy of nefopam hydrochloride (nefopam) to that of clonidine and meperidine in patients undergoing elective neurosurgical procedures. Three groups of patients were included in the study. ⋯ In group B, only 10% of patients receiving nefopam had postoperative shivering, Vo2, VcO2 and EE were significantly lower in patients treated with nefopam than those in the control group. No changes in CSFP, CPP or EEG were observed in group C. In conclusion, nefopam seems to be more effective than clonidine or meperidine in quickly suppressing shivering, without producing significant adverse reactions.