Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 1998
Randomized Controlled Trial Clinical TrialPreoperative adjuvant epidural tramadol: the effect of different doses on postoperative analgesia and pain processing.
Tramadol is an analgesic with combined opioid agonist and monoamine reuptake blocker properties, which may be useful as a perioperative analgesic and antinociceptive adjuvant. ⋯ Preoperative adjuvant epidural tramadol does not improve postoperative analgesia after lidocaine epidural anaesthesia compared to placebo. Tramadol 20 mg results in anti-analgesia and increased side-effects. While tramadol 100 mg depresses postoperative pain-processing, as measured by heat pain tolerance thresholds, this is not reflected in improved clinical pain measures.
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Acta Anaesthesiol Scand · Mar 1998
The end-systolic pressure-volume relationship and ventriculoarterial coupling in patients undergoing coronary artery bypass graft surgery.
The end-systolic pressure-volume relationship and analysis of ventriculoarterial coupling have been established as a useful tool to determine the left ventricular performance and arterial loading conditions. The purpose of this study was to evaluate the end-systolic pressure-volume relationship and ventriculoarterial coupling in anesthetized patients with either a normal heart or coronary artery disease (CAD) using a transesophageal echocardiography (TEE) monitor. ⋯ We found that patients with CAD and a normal LVEF had a physiological Ea/Ees identical to the control subjects. We also demonstrated that patients with CAD and a reduced LVEF showed a deterioration in Ea/Ees.
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Acta Anaesthesiol Scand · Mar 1998
Randomized Controlled Trial Multicenter Study Clinical TrialEfficacy of propacetamol in the treatment of postoperative pain. Morphine-sparing effect in orthopedic surgery. Italian Collaborative Group on Propacetamol.
Combined analgesic regimens have been suggested to improve the treatment of postoperative pain. The aim of our study was to evaluate the analgesic efficacy and tolerability of propacetamol, in combination with morphine. ⋯ These results confirm a significant morphine-sparing effect, significantly better scores in the final assessment by patients, and a good tolerability of propacetamol after orthopedic surgery. The drug may, therefore, represent a useful alternative to NSAIDs, as complementary drug to opioids, in the management of moderate/severe postoperative pain.
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Acta Anaesthesiol Scand · Mar 1998
Effects of inhaled nitric oxide on platelet-activating factor-induced pulmonary hypertension in dogs.
Platelet-activating factor (PAF), a lipid mediator released during endotoxin shock, induces pulmonary hypertension, systemic hypotension and cardiac dysfunction. In this study, we compared the effect of inhaled nitric oxide (NO) on PAF-induced pulmonary hypertension and NO metabolism with that on pulmonary hypertension induced by a stable thromboxane A2 mimetic, U46619. Since PAF-induced hypotension might be mediated by NO, the effect of inhaled NO combined with an intravenously administered NO synthase inhibitor, NG-nitro-L-arginine (L-NNA), on PAF-induced hemodynamic change was also investigated. ⋯ Inhaled NO at the dose of 5-40 ppm effectively reversed PAF-induced pulmonary hypertension, especially following pretreatment with L-NNA. Inhaled NO did not affect PAF-induced hypotension or cardiac dysfunction. These findings indicate that low concentrations of inhaled NO may be useful in reversing pulmonary hypertension in the endotoxemia where PAF may be one mediator.
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Acta Anaesthesiol Scand · Mar 1998
Randomized Controlled Trial Clinical TrialGranisetron prevents nausea and vomiting during spinal anaesthesia for caesarean section.
Nausea and vomiting during spinal anaesthesia for caesarean section are common and unpleasant complications. This study was undertaken to evaluate the efficacy of granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, for prophylactic treatment of nausea and vomiting in parturients undergoing nonemergent caesarean section under spinal anaesthesia. ⋯ Prophylactic use of granisetron in a minimum dose of 40 micrograms.kg-1 is effective for preventing nausea and vomiting during spinal anaesthesia for caesarean section.