Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2001
Randomized Controlled Trial Clinical TrialRopivacaine 1 mg x ml(-1) does not decrease the need for epidural fentanyl after hip replacement surgery.
Ropivacaine is a new long-acting local anesthetic. Laboratory trials have demonstrated a synergistic analgesic effect between intrathecal opioids and local anesthetics. We tested the hypothesis that addition of ropivacaine 1 mg x ml(-1) to epidural fentanyl (10 microg x ml(-1)) postoperatively decreases the need for fentanyl, improves the quality of analgesia and decreases the side-effects of fentanyl. ⋯ Addition of ropivacaine 1 mg x ml(-1) to epidural fentanyl 10 microg x ml(-1) did not significantly decrease the requirement for fentanyl administered for pain relief after hip replacement surgery.
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Acta Anaesthesiol Scand · Apr 2001
Randomized Controlled Trial Comparative Study Clinical TrialTotal knee replacement: a comparison of ropivacaine and bupivacaine in combined femoral and sciatic block.
Femoral and sciatic nerve block may improve post-operative analgesia following total knee replacement. ⋯ Femoral and sciatic blockade following intrathecal bupivacaine/diamorphine provided superior analgesia when compared with intrathecal bupivacaine/diamorphine alone. There were no significant clinical differences between the group receiving bupivacaine 7.5 mg x ml(-1) and the group receiving ropivacaine 7.5 mg x ml(-1).
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Acta Anaesthesiol Scand · Apr 2001
Randomized Controlled Trial Clinical TrialNo effect of L-arginine supplementation on pulmonary endothelial dysfunction after cardiopulmonary bypass.
Acetylcholine is an endothelium-dependent vasodilator through the L-arginine-nitric oxide pathway. After ischemia-reperfusion this effect is attenuated, also demonstrated in the pulmonary circulation after cardiopulmonary bypass. Administration of L-arginine has been shown to have a protective effect on endothelial function in reperfusion injury. The aim of the current study was to test the possible effect of L-arginine on the acetylcholine reactivity in the pulmonary circulation after cardiopulmonary bypass. ⋯ In the current study L-arginine had no protective effect on the pulmonary endothelium after cardiopulmonary bypass, measured as reactivity to an infusion of acetylcholine.
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Acta Anaesthesiol Scand · Apr 2001
Randomized Controlled Trial Clinical TrialEtomidate and thiopental inhibit platelet function in patients undergoing infrainguinal vascular surgery.
Postoperative platelet hyperaggregability following general anesthesia has been reported in patients undergoing major vascular surgery. In contrast, since anesthetic agents inhibited platelet function both in vitro and in vivo, an increased risk for postoperative bleedings due to prolonged platelet dysfunction has been discussed. Nevertheless, data describing platelet-affecting properties of induction agents such as etomidate and thiopental in patients undergoing major vascular surgery are lacking. ⋯ In the present study, etomidate and, to a minor extent, thiopental offered significant platelet inhibitory properties. Anesthetic-induced platelet inhibition may lead to higher transfusion rates and prolonged operation times. Therefore, anesthetic-related platelet inhibitory properties should be considered when searching for the anesthetic agent of choice, especially in patients with compromised hemostasis and co-existing bleeding disorders.
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Acta Anaesthesiol Scand · Apr 2001
Randomized Controlled Trial Clinical TrialEffects of olprinone, a new phosphodiesterase inhibitor, on gastric intramucosal acidosis and systemic inflammatory responses following hypothermic cardiopulmonary bypass.
Phosphodiesterase (PDE) III inhibitors have both an inotropic and a peripheral vasodilatory effect, and also inhibit the activation of macrophages. Thus a newly developed PDE III inhibitor, olprinone, could modify gastric intramucosal pH (pHi), systemic oxygen consumption, and systemic inflammatory responses in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). ⋯ Our results suggest that olprinone at 0.2 microg x kg(-1) x min(-1) suppresses gastric intramucosal acidosis and systemic inflammation following CPB.