Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 1995
Randomized Controlled Trial Clinical TrialDoes a local anaesthetic cream (EMLA) alleviate pain from heel-lancing in neonates?
EMLA cream is an effective local anaesthetic agent for venipunctures in adults and children. The aim of this double-blind, randomised, and placebo-controlled study was to evaluate the effect of EMLA when heel-lancing was performed in neonates. On their third day of life, fullterm healthy infants, who underwent testing for phenylketonuria (PKU) by heel-lancing, were consecutively included in the study. ⋯ The response to the nociceptive stimulation was assessed by studying the occurrence of a pain cry. No analgesic effect of EMLA was found. There were no adverse effects.
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Acta Anaesthesiol Scand · Nov 1995
Randomized Controlled Trial Comparative Study Clinical TrialComparison of propofol and increased doses of thiopentone for laryngeal mask insertion.
Conditions for insertion of the laryngeal mask were assessed following induction of anaesthesia with either propofol 2.5 mg/kg, thiopentone 5.0 mg/kg or thiopentone 6.0 mg/kg in 120 patients premedicated with diazepam 10 mg. Insertion following induction with thiopentone 5.0 mg/kg and 6.0 mg/kg resulted in a greater incidence of gagging (P < 0.001 and P < 0.05, respectively) compared with propofol 2.5 mg/kg.
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Acta Anaesthesiol Scand · Nov 1995
Randomized Controlled Trial Clinical TrialEffect of succinylcholine on subsequently administered mivacurium in children.
The interaction between mivacurium and succinylcholine when mivacurium was administered during the early recovery from succinylcholine block was studied in 30 children 2-12 years of age anaesthetized with propofolalfentanil-N2O-O2. Neuromuscular response was monitored by adductor pollicis EMG. Fifteen patients received 200 micrograms.kg-1 of mivacurium (Group M), and another fifteen received 1500 micrograms.kg-1 of succinylcholine followed by 200 micrograms.kg-1 of mivacurium when the first EMG response recovered to 5% of calibration value (Group SchM). ⋯ Times required for recovery of the first EMG response from 25 to 75% of full EMG recovery were 3.6 +/- 1.0 (mean +/- SD) and 4.0 +/- 0.7 min for the Groups M and SchM, respectively. The time from administration of mivacurium to the recovery of train-of-four ratio 0.70 was 13.2 +/- 3.3 min for the Group M and 13.6 +/- 3.1 min for the Group SchM (NS). Thus, in patients with normal pChE activity preceding administration of succinylcholine did not influence the recovery of neuromuscular function from subsequent mivacurium.
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Acta Anaesthesiol Scand · Nov 1995
Randomized Controlled Trial Comparative Study Clinical TrialComparison of preoperative with postoperative topical lidocaine spray on pain after tonsillectomy.
Seventy-five children aged 4-6 years scheduled for tonsillectomy were randomly allocated to receive either topical tonsillar spray with 10% lidocaine 4 mg kg-1 3 minutes before surgical incision; identical tonsillar spray after both tonsils had been removed; or no topical spray (control group). There were significant differences in postoperative pain between the lidocaine groups and the control group at 0.5 and one hour after awaking (P < 0.05). ⋯ Topical lidocaine seemed to have short-acting analgesic activity. The results of this study do not support the theory of pre-emptive analgesia.
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Acta Anaesthesiol Scand · Oct 1995
Randomized Controlled Trial Clinical TrialPhenylephrine in treating maternal hypotension due to spinal anaesthesia for caesarean delivery: effects on neonatal catecholamine concentrations, acid base status and Apgar scores.
Maternal and neonatal catecholamine concentrations, following the use of either phenylephrine or ephedrine to treat a drop in maternal blood pressure after spinal anaesthesia for caesarean delivery, were compared. Patients were randomly assigned to one of two groups: Group 1 patients (n = 20) were treated with ephedrine given as 5 mg intravenous bolus injections; Group 2 patients (n = 20) were treated with phenylephrine given as 40 micrograms intravenous bolus injections, for decreases in maternal systolic blood pressure to maintain maternal systolic blood pressure above 100 mmHg. Maternal vein (MV), umbilical vein (UV), and umbilical artery (UA) blood samples were taken at the time of delivery. ⋯ No significant differences in maternal characteristics, acid base values, incidence of nausea and vomiting, and Apgar scores were observed between groups. Phenylephrine appears to be as safe and effective as ephedrine in treatment of drop in blood pressure in healthy non-labouring parturients undergoing caesarean delivery. The use of phenylephrine was also associated with significantly lower noradrenaline concentrations in both mother and neonate.