Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2004
Randomized Controlled Trial Clinical TrialSimilar excitation after sevoflurane anaesthesia in young children given rectal morphine or midazolam as premedication.
Sevoflurane is a rapid-acting volatile anaesthetic agent frequently used in paediatric anaesthesia despite transient postoperative symptoms of cerebral excitation, particularly in preschool children. This randomised and investigator-blinded study was designed to evaluate whether premedication with an opioid might reduce non-divertible postoperative excitation more than premedication with a benzodiazepine in preschool children anaesthetized with sevoflurane. ⋯ In this study morphine for premedication in young children anaesthetized with sevoflurane was associated with similar postoperative and higher preoperative OPDS scores compared with midazolam. These findings indicate that substitution of morphine for midazolam is no useful way of reducing clinical excitation after sevoflurane anaesthesia.
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Acta Anaesthesiol Scand · Nov 2004
Randomized Controlled Trial Comparative Study Clinical TrialClonidine vs. midazolam as premedication in children undergoing adeno-tonsillectomy: a prospective, randomized, controlled clinical trial.
Clonidine administration in the setting of paediatric anaesthesia is associated with a number of desirable effects, e.g. preoperative sedation, analgesia and reduced anaesthetic requirements. The aim of the current study was to compare postoperative outcome variables using a prospective, randomized, double-blind design after premedication with clonidine or midazolam. ⋯ Rectal premedication with clonidine was associated with a significant reduction of pain in the early postoperative period compared to midazolam and was also associated with moderately increased sedation during the first 24 postoperative hours. The sedative effect of clonidine is in agreement with the unambiguous finding of a parental preference for a calm and sedated child during the first 24 postoperative hours.
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Acta Anaesthesiol Scand · Nov 2004
Comment Historical ArticleFurther commentary on Denmark's 1952-53 poliomyelitis epidemic, especially regarding mortality; with a correction.
Berthelsen and Cronqvist recently published an article in Acta Anaesthesiologica Scandinavica including aspects which could lead on to further discussion about the Danish 1952-53 poliomyelitis epidemic. This paper considers how Bjørn Ibsen's initial approach to treatment during the epidemic was successful, as well as how it could have failed; the roles played by ventilatory failure vs. gross neurologic destruction in causing deaths; and compilations from publications of statistics concerning mortality of the epidemic. The Blegdam Hospital concept of 'life-threatening poliomyelitis' is revisited, along with its division into six anatomico-clinical categories for the 345 patients so classified. ⋯ Lassen, has been freely used. Some folklore about aspects of management is mentioned. In the light of other recent research by Dr Berthelsen an essential correction is needed in dating 'Bjørn Ibsen's Day', amending 26 August 1952 to the 27th.
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Acta Anaesthesiol Scand · Nov 2004
Randomized Controlled Trial Comparative Study Clinical TrialWomen report more pain on injection of a precurarization dose of rocuronium: a randomized, prospective, placebo-controlled trial.
The purpose of this study was to investigate whether gender influences the perception of pain on injection of rocuronium. ⋯ Women experienced more pain on injection of rocuronium than men, moreover this is an additional evidence for gender-related differences in pain perception. When rocuronium is used as a precurarization agent, an analgesic pretreatment (e.g. opioids) should be considered, especially for female patients.
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Acta Anaesthesiol Scand · Nov 2004
Randomized Controlled Trial Clinical TrialRocuronium attenuates oculocardiac reflex during squint surgery in children anesthetized with halothane and nitrous oxide.
The oculocardiac reflex (OCR) may be activated during squint surgery. The aim of this study was to test whether rocuronium 0.4 mg kg(-1) could reduce the frequency of OCR, and also whether a single dose of succinylcholine 1 mg kg(-1) could affect the frequency of OCR during anesthesia with halothane in a nitrous oxide/oxygen mixture. ⋯ Rocuronium reduced the frequency of OCR, mainly by reducing the incidence of supraventricular and ventricular premature beats.