Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Dec 1980
Comparative Study Clinical TrialDouble-blind, multiple-dose comparison of buprenorphine and morphine in postoperative pain.
The analgesic profile and side-effects of buprenorphine 0.3 mg and morphine 10 mg intramuscularly were compared postoperatively in a double-blind, non-crossover, multiple-dose study. When the patient complained of moderate to severe postoperative pain after halothane-relaxant anesthesia for upper abdominal surgery, the first test dose of either drug was given. Subsequent similar doses of buprenorphine 0.3 mg or morphine 10 mg were given when required (maximum ten doses). ⋯ Other effects of the two drugs on vital signs were similar. The incidence of other side-effects was fairly similar after both analgesics. The patients' subjective appraisal favoured buprenorphine.
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A twin-tube system for nitrous oxide analgesia in dental surgeries is described. The system is a non-polluting modification of the Mapleson A system, employing the principle of co-axial tubing introduced by Bain & Spoerel (1972). Active, continuous and calibrated gas removal takes place via the co-axial tubing by means of an ejector flowmeter. ⋯ The system described is safe and easy to handle. It is made of light-weight material and is adaptable to the equipment available. No rebreathing takes place when using a fresh gas inflow of 150 ml/kg body weight/min.
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Acta Anaesthesiol Scand · Aug 1980
Comparative StudyComparison of Glycopyrrolate, atropine and hyoscine in mixture with neostigmine for reversal of neuromuscular block following closed mitral valvotomy.
Atropine, glycopyrrolate and hyoscine were compared in a mixture with neostigmine for the reversal of neuromuscular block in patients undergoing closed mitral valvotomy. Both atropine and glycopyrrolate were effective in counteracting the muscarinic effects of neostigmine. ⋯ The control of secretions was better with glycopyrrolate. Administration of hyoscine was associated with unacceptable falls in heart rate and is not recommended.
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Acta Anaesthesiol Scand · Aug 1980
Randomized Controlled Trial Comparative Study Clinical TrialEpidural versus general anaesthesia for total hip arthroplasty in elderly patients.
Sixty elderly patients were given at random either epidural analgesia with bupivacaine 0.75% or general anaesthesia with thiopentone, fentanyl, pancuronium, N2O/O2 for total hip replacement. Preoperatively the patients were of equal physical status with normal and similar laboratory values. All patients were mentally normal for their age. ⋯ Two patients in the epidural group had symptoms of pulmonary embolism postoperatively. Thus elderly patients appear to do better after hip replacement with less deterioration of cerebral and pulmonary functions when given epidural analgesia than when surgery is performed under general anaesthesia. These patients should therefore be offered epidural analgesia whenever possible.
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Acta Anaesthesiol Scand · Aug 1980
Effects of the level of CPAP on central haemodynamics and oxygen transport.
The effects of different levels of continuous positive airway pressure (CPAP) on central haemodynamics and oxygen transport were studied in ten spontaneously breathing male patients who had undergone aortocoronary bypass graft operation 18 h earlier. With increasing CPAP levels ranging from 5 cmH2O(0.49kPa)(CPAP 5) to 15 cmH2O(1.47kPa)(CPAP 15), the cardiac index was found to decrease significantly, while the intraluminal pulmonary capillary wedge and right atrial pressures increased simultaneously. The mean systemic arterial pressure remained unaltered, while the mean pulmonary arterial pressure increased with increasing CPAP. ⋯ Thus, low level CPAP might be beneficial in maintaining proper lung volume in an intubated patient after aortocoronary bypass surgery. The observations also suggest that, in these patients, CPAP levels exceeding 10 cmH2O bring about cardiac depression leading to an undesirable reduction in systemic oxygen transport. Mixed venous blood oxygen tension may offer information useful in the adjustment of the level of CPAP.