Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 1996
Randomized Controlled Trial Clinical TrialDoes epidural sufentanil provide effective analgesia per- and postoperatively for abdominal aortic surgery?
To assess the efficacy of epidural sufentanil in providing per- and postoperative analgesia, 40 patients undergoing elective abdominal aortic surgery received either 50 mu g sufentanil in 10 ml normal saline solution (n = 20, ES group) or 10 ml normal saline (n = 20, control group) via a thoracic epidural catheter. The study solution was given (double-blind and at random) after the patients had been anaesthetized with i.v. midazolam, sufentanil and vecuronium. Anaesthesia was maintained with 60% nitrous oxide in oxygen and halothane at a 1% inspiratory concentration. ⋯ The mean dose administered i.v. did not differ significantly between the two groups: 105 +/- 109.5 mu g vs 138.5 +/- 126.9 mu g (mean +/- SD) in 5 and 13 patients, respectively. No cardiovascular changes were observed after the epidural bolus dose. Postoperative analgesia, consisting of a continuous epidural infusion of 50 mu g sufentanil in 50 ml bupivacaine 0.125% at a rate of 6-10 ml/h after a bolus dose of 10 ml of this solution, was adequate in the majority of patients, as determined by VAS-scores assessed during the epidural treatment (4.3 +/- 1.5 days).
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Acta Anaesthesiol Scand · Jan 1996
Randomized Controlled Trial Clinical TrialIntravenous sedation for retrobulbar injection and eye surgery: diazepam and/or propofol?
Principle goals of sedation for eye surgery are to provide patient comfort and to allow the patient to stay calm during both retrobulbar injection and surgery. Insufficient sedation may not prevent the patient from moving during retrobulbar injection, whereas very deep sedation may result in respiratory complications during surgery. The aim of the present study was to evaluate the effectiveness and suitability of a combination of diazepam and propofol for sedation for both application of retrobulbar block and subsequent elective eye surgery. ⋯ No severe side effects induced by sedation were noted in any of the study groups. The combination of diazepam and propofol proved able to provide a reliable degree of sedation with minimal side effects for both retrobulbar block and surgery. The combination was clearly superior to the sedation induced by propofol or diazepam alone.
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Acta Anaesthesiol Scand · Jan 1996
Randomized Controlled Trial Comparative Study Clinical TrialHaemodynamic effects of high-dose vecuronium compared with pancuronium in beta-blocked patients with coronary artery disease during fentanyl-diazepam-nitrous oxide anaesthesia.
Different combinations of neuromuscular blockers and opioids have been used in patients with angina pectoris to provide cardiovascular stability and reduce risk of myocardial ischaemia during anaesthesia. ⋯ High-dose administration of vecuronium has minimal haemodynamic effects and may thus offer a better alternative than pancuronium for long-lasting neuromuscular blockade in patients with coronary artery disease during fentanyl-diazepam-nitrous oxide anaesthesia.
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Acta Anaesthesiol Scand · Nov 1995
Randomized Controlled Trial Clinical TrialIntra-arterial regional anaesthesia for hand surgery with alkalinized 0.5% lignocaine.
Intra-arterial regional anaesthesia (IARA) for hand surgery is an old, forgotten technique. One of the causes of low popularity may be a scalding sensation in the hand during intra-arterial injection of lignocaine, which may be caused by low pH of lignocaine's solution. In this randomized, double-blind study, normal (pH 5.2-5.3) or alkalinized (pH 7.2-7.3) preservative-free 0.5% lignocaine 1.5 mg kg-1 was injected into the radial arteries of forty adult patients to produce anaesthesia for ambulatory hand surgery. ⋯ Nine patients in group 1 and seven in group 2 developed minor bruises after cannulation (NS). No other sequelae of intra-arterial injections were observed. We conclude that alkalinized 0.5% lignocaine was less painful on injection than normal lignocaine and should be preferred for intra-arterial anaesthesia for hand surgery.
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Acta Anaesthesiol Scand · Nov 1995
Randomized Controlled Trial Clinical TrialEffects of ephedrine on oxygen consumption and cardiac output.
Bolus doses of ephedrine are often used by anaesthesiologists for intraoperative hypotension. This randomized single-blind cross-over study was designed to simultaneously evaluate circulatory, respiratory and metabolic effects of intravenously given ephedrine in 12 healthy male volunteers. Oxygen uptake and carbon dioxide excretion were measured with indirect calorimetry and non-invasive transthoracic electrical bioimpedance was used for cardiac output measurements. ⋯ There were no significant changes in the quotient between oxygen uptake rate and cardiac index, VO2/CI during the 30 min study period. The O2 saturation was not altered. The present study indicates that ephedrine increases oxygen demand and supply in a similar magnitude.