Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Jan 1999
Randomized Controlled Trial Comparative Study Clinical TrialThe effects of tramadol on postoperative nausea, vomiting and headache after ENT surgery. A placebo-controlled comparison with equipotent doses of nalbuphine and pethidine.
Opioids given as adjuncts to balanced inhalational anaesthesia augment postoperative nausea and vomiting (PONV). Tramadol, equipotent to pethidine, does not depress respiration, but can cause an increase in blood pressure and headache via its monoaminergic actions. Nalbuphine, ten times as potent as pethidine, has a ceiling respiratory depressant and ceiling analgesic effect at > 0.3 mg.kg-1. We compared the effects of equipotent doses of tramadol and nalbuphine (3.0 and 0.3 mg.kg-1, respectively) given as analgesic with induction of anaesthesia on emesis during recovery from anaesthesia and on PONV and headache until 24 h after ENT surgery, using saline (0.2 ml.kg-1) and an equipotent dose of pethidine (1.5 mg.kg-1) as controls. ⋯ It is concluded that tramadol, nalbuphine and pethidine have similar emetic effect in the doses and manner used, and that tramadol does not increase the incidence of post-operative headache when used as peroperative analgesic.
-
Acta Anaesthesiol Scand · Jan 1999
Randomized Controlled Trial Comparative Study Clinical TrialPain on injection of propofol: the mitigating influence of metoclopramide using different techniques.
Metoclopramide administered intravenously (i.v.) immediately before injection of propofol, after mixing with propofol, or after a rubber tourniquet for 1 min before propofol injection will reduce pain induced by propofol injection. In this study, these three different techniques in reducing propofol injection pain with metoclopramide were compared with lidocaine or saline to evaluate the most effective method in reducing propofol injection pain. ⋯ We conclude that i.v. retention of metoclopramide with tourniquet is as good as lidocaine and may be a useful alternative for reducing pain on propofol injection.
-
Acta Anaesthesiol Scand · Jan 1999
Randomized Controlled Trial Clinical TrialIntra-articular buprenorphine after knee arthroscopy. A randomised, prospective, double-blind study.
Demonstration of peripheral opioid receptors in inflamed synovia supports the concept of peripheral opioid analgesia. The aim of this study was to evaluate the analgesic effect of intra-articular administration of buprenorphine after knee arthroscopy. ⋯ Intra-articular buprenorphine and i.a. bupivacaine, both produced equally good postoperative pain control and allowed a significant reduction of analgesic requirement after knee arthroscopy.
-
Acta Anaesthesiol Scand · Jan 1999
Historical ArticleFinland's first anaesthesia revealed by newspapers.
According to the literature on the history of anaesthesia, Finland's first anaesthesia was given on March 8, 1847 for a ligature of an aneurysm of the subclavian artery. It has, however, not been possible to verify the date with certainty. We therefore wanted to find out whether newspapers might give additional information and how this exceptionally important medical invention had been received by the Finnish newspapers. ⋯ Finland's first anaesthesia was given on February 16, 1847, which is three weeks earlier than had been previously assumed.
-
Acta Anaesthesiol Scand · Jan 1999
Intestinal and hepatic perfusion and metabolism in hypodynamic endotoxic shock. Effects of nitric oxide synthase inhibition.
Inhibition of nitric oxide synthase (NOS) has been claimed to be beneficial in septic shock. We investigated the overall and regional effects of a NOS-inhibitor on perfusion and metabolism during severe endotoxic shock. ⋯ In hypodynamic endotoxic shock, L-NAME infusion enhanced pulmonary vasoconstriction and increased left ventricular afterload. The resulting hypoperfusion caused an increase in mortality. The effects of L-NAME on global and mesenteric blood flow and metabolism were similar, while L-NAME had no additional effects on hepatic hypoperfusion or oxygen extraction. Thus, nitric oxide does not seem to be a major factor in the preservation of hepatic perfusion during unresuscitated endotoxic shock.