Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Sep 2003
Randomized Controlled Trial Clinical TrialEffects of 0.5 and 1.0 MAC isoflurane, sevoflurane and desflurane on intracranial and cerebral perfusion pressures in children.
Isoflurane has been a commonly used agent for neuroanesthesia, but newer agents, sevoflurane and desflurane, have a quicker onset and shorter emergence from anesthesia and are increasingly preferred for general pediatric anesthesia. But their effects on intracranial pressure (ICP) and cerebral perfusion pressure (CPP), especially in pediatric patients with already increased ICP, have not been well documented. ⋯ 0.5 and 1.0 MAC isoflurane, sevoflurane and desflurane in N2O all increased ICP and reduced MAP and CPP in a dose-dependent and clinically similar manner. There were no baseline dependent increases in ICP from 0 to 1.0 MAC with isoflurane or sevoflurane, but ICP increased somewhat more, although statistically insignificant, with higher baseline values in patients given desflurane. The effect of MAP on CPP is 3-4 times higher than the effect of the increases in ICP on CPP and this makes MAP the most important factor in preserving CPP. In children with known increased ICP, intravenous anesthesia may be safer. However, maintaining MAP remains the most important determinant of a safe CPP.
-
Acta Anaesthesiol Scand · Sep 2003
Randomized Controlled Trial Clinical TrialPatient-controlled regional analgesia (PCRA) with ropivacaine after arthroscopic subacromial decompression.
The aim of the study was to evaluate postoperative analgesia and safety of wound instillation of ropivacaine either by a single dose or a patient-controlled regional anaesthesia (PCRA) technique. ⋯ Preoperative intrabursal prilocaine with epinephrine + postoperative subacromial administration of ropivacaine by PCRA-technique provided the most effective analgesia with no major side-effects. The free plasma concentrations of ropivacaine were far below toxic concentrations.
-
Acta Anaesthesiol Scand · Sep 2003
Randomized Controlled Trial Clinical TrialIntravenous clonidine prolongs bupivacaine spinal anesthesia.
Prolongation of spinal anesthesia by oral clonidine premedication has been known. We hypothesized that intravenous clonidine administered after the spinal block may prolong spinal anesthesia. ⋯ Intravenous clonidine administration within 1 h after the spinal block prolonged bupivacaine spinal anesthesia for approximately 1 h without adverse effects.