Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Jan 1997
Randomized Controlled Trial Clinical TrialPharmacokinetics and pharmacodynamics of controlled-release opioids.
While pharmacokinetic/pharmacodynamic relationships for opioids have not been consistently demonstrable or sufficiently predictive, there remain compelling reasons to pursue such relationships. Among the reasons for pursuing pharmacokinetic/ pharmacodynamic relationships is the prospect of predicting the time-action characteristics of new therapeutics on the basis of early studies in normals using pharmacodynamic surrogates for analgesia. The realization of such a model could improve the efficiency of development of analgesics. ⋯ Concurrent assessments included vital signs and opioid effect VAS questionnaires. The studies demonstrated significant relationships between plasma oxycodone (but not oxymorphone) and pharmacodynamic surrogates (particularly VAS "drug effect") and were predictive of the 12-hour duration of pain control and prompt onset of analgesia subsequently demonstrated in multiple clinical studies involving patients with various pathological pain syndromes. The results suggest that investigators can make earlier, accurate predictions of opioid analgesic pharmacodynamics in patients based on pharmacokinetic/pharmacodynamic studies in normal volunteers.
-
Acta Anaesthesiol Scand · Nov 1996
Randomized Controlled Trial Clinical TrialThe use of countercurrent heat exchangers diminishes accidental hypothermia during abdominal aortic aneurysm surgery.
Perioperative hypothermia is common and likely contributes to morbidity, but the efficacy of prophylactic fluid warning has hardly been analyzed systematically. We tested the hypothesis that the use of an infusion/blood warmer, based on the principle of countercurrent heat exchange, reduces incidence and degree of severe hypothermia following aortic surgery. ⋯ The efficacy of fluid/blood warmers has hitherto only been evaluated in bench tests. Our results demonstrate that the use of heat exchangers alone, while not completely preventing hypothermia, markedly reduces the incidence of severe perioperative hypothermia, and lessens its degree during abdominal aortic aneurysm surgery.
-
Acta Anaesthesiol Scand · Nov 1996
Randomized Controlled Trial Comparative Study Clinical TrialEffect of pre- vs postoperative tonsillar infiltration with local anesthetics on postoperative pain after tonsillectomy.
Since pre-incisional peritonsillar infiltrations of local anesthetic solutions have been suggested to reduce postoperative pain after tonsillectomy, we compared the efficacy of either pre- or postoperative local anesthetic infiltration upon post-tonsillectomy pain. ⋯ These results suggest that the timing of peritonsillar infiltration with bupivacaine is not of clinical importance and does not affect the quality of postoperative analgesia in patients undergoing tonsillectomy.
-
Acta Anaesthesiol Scand · Nov 1996
Randomized Controlled Trial Comparative Study Clinical TrialFluid therapy with Ringer's solution versus Haemaccel following coronary artery bypass surgery.
Crystalloid and colloid infusion can be used in volume therapy following heart surgery. In this prospective, randomised study we compared Ringer's solution (group R) to Haemaccel (group H) following coronary artery bypass grafting. ⋯ We conclude that volume therapy with Haemaccel following heart surgery requires less volume and achieves better filling of the circulation compared to Ringer's solution.
-
Acta Anaesthesiol Scand · Nov 1996
Randomized Controlled Trial Clinical TrialIntra-articular tenoxicam relieves post-arthroscopy pain.
Nonsteroidal anti-inflammatory drugs have been documented to be effective in the treatment of postoperative pain. The aim of this study was to evaluate the analgesic effect of local intra-articular injection of tenoxicam compared with intravenous injection on postoperative pain after arthroscopy. ⋯ Intra-articular tenoxicam 20 mg provided better analgesia and decreased the requirements for postoperative analgesic compared with i.v. tenoxicam 20 mg.