Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 1994
Randomized Controlled Trial Comparative Study Clinical TrialAn assessment of prilocaine as a topical anaesthetic agent for fibreoptic bronchoscopy in comparison with lidocaine.
We have evaluated prilocaine as a topical anaesthetic agent for fibreoptic bronchoscopy in comparison with lidocaine in terms of efficacy and safety. Forty patients were included in a randomised double-blind parallel-group study. Efficacy was assessed using visual analogue scales, a patient ranking scale and the number of doses of local anaesthetic and intravenous sedative required. ⋯ However, the median peak plasma concentration of prilocaine (0.5 micrograms.ml-1) was less than one-third that of lidocaine (1.76 micrograms.ml-1). The merits and hazards of using multiple-regression modelling to improve the precision of the analysis of the results are considered. We conclude that prilocaine can be used successfully as a topical anaesthetic agent for fibreoptic bronchoscopy and is associated with a lower risk of toxicity.
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Acta Anaesthesiol Scand · Jul 1994
Randomized Controlled Trial Comparative Study Clinical TrialThe haemodynamic response to the insertion of the laryngeal mask airway: a comparison with laryngoscopy and tracheal intubation.
The haemodynamic response to the insertion of the laryngeal mask airway (LMA) was assessed and compared to that of laryngoscopy and tracheal intubation in a study of forty patients (ASA 1) randomly allocated into two groups and anaesthetised using a standard balanced anaesthetic technique. The results show that the changes in all cardiovascular parameters measured following LMA insertion were significantly less (P < 0.05) when compared with those following laryngoscopy and tracheal intubation. We conclude that airway management with the LMA may be used to avoid the haemodynamic response to tracheal intubation where such a response is undesirable.
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Acta Anaesthesiol Scand · Jul 1994
Randomized Controlled Trial Clinical TrialIbuprofen in the treatment of postoperative pain in small children. A randomized double-blind-placebo controlled parallel group study.
The efficacy of ibuprofen as a pre-emptive analgesic for postoperative pain was investigated in 81 children in the age between one and four years subjected to elective surgery. The patients were randomized into two groups receiving rectally either ibuprofen 40 mg.kg-1.d-1, divided into four equal doses, or placebo in a double blind manner. Additional pain relief was provided by morphine. ⋯ Heart rate and arterial blood pressure were lower in children who received ibuprofen, probably reflecting better analgesia. The side effects were mild and similar in both groups. We conclude that rectal ibuprofen is a safe analgesic in children in the age between 1 and 4 years and reduces the need of opioids for postoperative pain relief.
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Acta Anaesthesiol Scand · Jul 1994
Randomized Controlled Trial Clinical Trial Retracted PublicationInfluence of volume replacement with different HES-solutions on microcirculatory blood flow in cardiac surgery.
A variety of hydroxyethyl starch HES preparations with different molecular weight average (Mw) and molar substitution (MS) is available for volume replacement during acute normovolemic haemodilution (ANH). Particularly with regard to microcirculation, the ideal solution for volume therapy has not been found. The influence of four different HES preparations on macro- and microcirculation was investigated in 40 patients scheduled for elective aorto-coronary bypass grafting and undergoing ANH (preoperative withdrawn blood: 10 ml.kg-1): 1) 6% HES with Mw of 450,000 dalton and MS of 0.7; 2) 6% HES with Mw of 200,000 dalton and MS of 0.5; 3) 6% HES with Mw of 200,000 dalton and MS of 0.62; 4) 6% HES with Mw of 40,000 dalton and MS of 0.5. ⋯ After ANH, skin capillary blood flow measured at the forehead decreased in all patients except in patients of group 2 (200/0.5: max. +18%). Group 3 (200/0.62) showed the highest decrease in forehead-LDF. During CPB, forehead-LDF decreased significantly in groups 3 (200/0.62) and 4 (40/0.5).(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · May 1994
Randomized Controlled Trial Clinical TrialInterpleural or thoracic epidural analgesia for pain after thoracotomy. A double blind study.
The analgetic effect of bupivacaine given epidurally or interpleurally after thoracotomy was investigated in a randomized, double blind, placebo controlled study. 32 patients with both an epidural and an interpleural catheter, were randomized to receive either interpleural or epidural analgesia. The interpleural group was given bupivacaine 5 mg.ml-1 with 5 microgram epinephrine as a 30 ml interpleural bolus, followed by a continuous infusion starting at a rate of 7 ml per hour and epidurally a bolus of 0.9% NaCl followed by a continuous infusion of 0.9% NaCl. ⋯ Adequacy of pain relief was evaluated with the Prins-Henry pain scale. Morphine requirement was registered, there was no difference between the groups in pain scores or need for additional morphine.