Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2004
Randomized Controlled Trial Comparative Study Clinical TrialHigh-dose bupivacaine, levobupivacaine and ropivacaine in axillary brachial plexus block.
Racemic bupivacaine is clinically similar to levobupivacaine, or ropivacaine. The drugs were compared in brachial plexus block for the first time in the same randomized and double-blind study. ⋯ Ropivacaine-HCl 5 mg ml(-1) produced slightly better sensory and motor block intensity than the same dose of levobupivacaine-HCl. General success in relation to surgery and in the duration of the blocks was similar in the three groups.
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Acta Anaesthesiol Scand · May 2004
Review Comparative StudyA systematic review of COX-2 inhibitors compared with traditional NSAIDs, or different COX-2 inhibitors for post-operative pain.
We have reviewed the analgesic efficacy of cyclooxygenase-2 (COX-2) inhibitors compared with traditional non-steroidal anti-inflammatory drugs (NSAIDs), different COX-2 inhibitors, and placebo in post-operative pain. ⋯ Rofecoxib 50 mg and parecoxib 40 mg have an equipotent analgesic efficacy relative to traditional NSAIDs in post-operative pain after minor and major surgical procedures, and after dental surgery these COX-2 inhibitors have a longer duration of action. Besides, rofecoxib 50 mg provides superior analgesic effect compared with celecoxib 200 mg.
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Acta Anaesthesiol Scand · May 2004
Randomized Controlled Trial Clinical TrialPreoperative stellate ganglion blockade prevents tourniquet-induced hypertension during general anesthesia.
Prolonged and excessive inflation of pneumatic tourniquets leads to a hyperdynamic circulatory response. Sympathomimetic activity is an important factor in tourniquet-induced hypertension. Stellate ganglion block specifically blunts sympathetic efferent nerves and prevents hypertension induced by sympathomimetic stimulation. The present study was performed to investigate the effects of stellate ganglion block (SGB) on arterial pressure and heart rate during prolonged tourniquet use under general anesthesia. ⋯ Ipsilateral SGB attenuated the hyperdynamic response mediated by prolonged tourniquet inflation during knee arthroscopy.
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Acta Anaesthesiol Scand · May 2004
Comparative Study Clinical TrialComparison of the concentration-dependent effect of sevoflurane on the spinal H-reflex and the EEG in humans.
It has been shown that spinal reflexes such as the H-reflex predict motor responses to painful stimuli better than cortical parameters derived from the EEG. The precise concentration-dependence of H-reflex suppression by anaesthetics, however, is not known. Here we investigated this concentration-response relationship and the equilibration between the alveolar and the effect compartment for sevoflurane. ⋯ The differences in EC(50) and slope of the concentration-response relationships for H-reflex suppression and the EEG parameters point to different underlying mechanisms. In addition, the differences in time constant for equilibration between alveolar and effect compartment confirm the notion that immobility is caused at a different anatomic site than suppression of the EEG.
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Acta Anaesthesiol Scand · May 2004
Comparative Study Clinical TrialComparison of the neuromuscular blocking effect of cisatracurium and atracurium on the larynx and the adductor pollicis.
Cisatracurium unlike atracurium is devoid of histamine-induced cardiovascular effects and this alone would be the greatest advantage in replacing atracurium for the facilitation of tracheal intubation. On the other hand, 2 ED(95) doses of cisatracurium (100 micro g/kg) do not yield satisfactory intubating conditions such as those seen with equipotent doses of atracurium and therefore the recommended intubating dose of cisatracurium is 3 ED(95). To understand this discrepancy better, we evaluated the potency and onset of atracurium and cisatracurium directly at the larynx adductors in humans. ⋯ The slow onset time at the laryngeal muscles after cisatracurium can be explained by the higher potency as compared with atracurium.