Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2008
Randomized Controlled TrialItraconazole, a potent inhibitor of P-glycoprotein, moderately increases plasma concentrations of oral morphine.
Individual variation in opioid response is considerable, partly due to pharmacokinetic factors. Transporter proteins are becoming increasingly interesting also in the pharmacokinetics of opioids. The efflux transporter P-glycoprotein can affect gastrointestinal absorption and tissue distribution, particularly brain access of many opioids. The aim of this study was to evaluate whether itraconazole, which is a potent inhibitor of P-glycoprotein and CYP3A4, would change the pharmacokinetics or the pharmacodynamics of oral morphine. ⋯ Itraconazole moderately increases plasma concentrations of oral morphine, probably by enhancing its absorption by inhibiting intestinal wall P-glycoprotein. A possible improvement of morphine penetration to the brain could not be observed.
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Acta Anaesthesiol Scand · Nov 2008
Skin conductance as a means to predict hypotension following spinal anaesthesia.
Hypotension following spinal anaesthesia (SA) is common, especially in the elderly. Elevated sympathetic tone has been shown to correlate with severe hypotension after SA. The aim of this prospective trial was to investigate skin conductance (SC), as a measure of sympathetic tone, to predict hypotension after SA. ⋯ AUC B, as a parameter of SC, may predict severe arterial hypotension after SA in the elderly.
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Acta Anaesthesiol Scand · Nov 2008
Randomized Controlled TrialEffect of intraoperative magnesium sulphate infusion on pain relief after laparoscopic cholecystectomy.
The aim of the study is to evaluate the analgesic efficiency of perioperative magnesium sulphate infusion in patients undergoing laparoscopic cholecystectomy (LC). ⋯ Per-operative 50 mg/kg magnesium sulphate infusion is effective in reducing post-operative pain in patients undergoing LC.
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Acta Anaesthesiol Scand · Nov 2008
Randomized Controlled Trial Comparative StudyEpidural sufentanil provides better analgesia from 24 h after surgery compared with epidural fentanyl in children.
Studies comparing epidural fentanyl and sufentanil in adults reported a similar analgesic effect with variable side effects. We hypothesized that epidural fentanyl and sufentanil will have a similar analgesic effect in children undergoing urological surgery. ⋯ Epidural sufentanil provides better analgesia from 24 h after surgery compared with epidural fentanyl in infants and children undergoing urological surgery. The incidence of pruritus in the sufentanil group was higher than that in the fentanyl group.
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Acta Anaesthesiol Scand · Nov 2008
Randomized Controlled Trial Comparative StudyCaudal midazolam does not affect sevoflurane requirements and recovery in pediatric day-case hernioplasty.
This prospective, randomized, double-blind study aimed to determine whether caudal midazolam combined with ropivacaine affects anesthetic requirements, recovery profiles, and post-operative analgesia compared with ropivacaine alone in pediatric day-case hernioplasty. ⋯ Caudal midazolam (50 microg/kg) added to 2% ropivacaine did not influence sevoflurane requirement or recovery but improved post-operative analgesia compared with ropivacaine alone in pediatric day-case hernioplasty.