Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2006
Randomized Controlled Trial Comparative StudyA combination of fentanyl-midazolam-propofol provides better intubating conditions than fentanyl-lignocaine-propofol in the absence of neuromuscular blocking agents.
The use of propofol and adjuvants such as opioids, benzodiazepines and local anaesthetic agents, may provide adequate conditions for tracheal intubation without the need for neuromuscular blocking agents. In this randomized, double-blind study, intubating conditions after induction of anaesthesia with propofol, midazolam and fentanyl were compared with those after propofol, lignocaine and fentanyl. ⋯ We conclude that the fentanyl, midazolam, propofol combination more reliably provides acceptable conditions for intubation than the fentanyl, lignocaine, propofol combination. Intubation was successful in all patients receiving the fentanyl, midazolam, propofol combination.
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Acta Anaesthesiol Scand · Sep 2006
Randomized Controlled TrialIntravenous glucose-insulin-potassium during off-pump coronary artery bypass surgery does not reduce myocardial injury.
This randomized, double-blind, placebo-controlled study was designed to determine whether an intra-operative, intravenous infusion of glucose-insulin-potassium (GIK) could be helpful in the prevention of myocardial ischemia and in the maintenance of intra-operative cardiac performance in patients undergoing off-pump coronary artery bypass (OP-CAB) surgery. ⋯ The results suggest that the intravenous administration of GIK during OP-CAB surgery neither reduces myocardial damage nor improves intra-operative cardiac performance in patients without contractile dysfunction.
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Acta Anaesthesiol Scand · Sep 2006
Randomized Controlled TrialAnti-inflammatory effect of high-dose insulin treatment after urgent coronary revascularization surgery.
The administration of insulin has been shown to exert cardioprotective and immunomodulatory properties. Ischemia and inflammation are typical features of acute coronary syndrome, thus it was hypothesized that high-dose glucose-insulin-potassium (GIK) treatment could suppress the systemic inflammatory reaction and attenuate myocardial ischemia-reperfusion injury in patients with unstable angina pectoris after urgent coronary artery bypass surgery. ⋯ High-dose insulin treatment has potential anti-inflammatory properties independent of its ability to lower blood glucose levels. Even profound suppression of free fatty acid levels, the attenuation of myocardial ischemia-reperfusion injury was not detected.
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Acta Anaesthesiol Scand · Sep 2006
Randomized Controlled Trial Multicenter StudyLack of analgesic effect of parecoxib following laparoscopic cholecystectomy.
The cyclo-oxygenase-2 inhibitor, parecoxib, can be administered parenterally. The recommended dose for post-operative use is 40 mg twice daily, which may not be the appropriate dose for the treatment of visceral pain. We studied the effect of a single dose of parecoxib of either 40 or 80 mg in laparoscopic cholecystectomy, and its effect on opioid-induced side-effects. ⋯ The recommended dose of parecoxib, 40 mg, is not effective for the treatment of pain during the early post-operative period after laparoscopic cholecystectomy. Doubling the dose to 80 mg seems to improve the results.