Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 1993
Randomized Controlled Trial Comparative Study Clinical TrialInterpleural bupivacaine for analgesia during chest drainage treatment for pneumothorax. A randomized double-blind study.
The ability of interpleural analgesia to reduce the pain caused by an indwelling chest drain was evaluated in 22 patients treated for spontaneous pneumothorax. Intermittent 8-hourly bolus injections of 20 ml bupivacaine 0.5% with epinephrine were compared with placebo in a randomized double-blind fashion. Visual analogue pain scale (VAS) scores were registered after the 1st, 2nd, 4th, 7th and 10th injections. ⋯ Parenteral morphine consumption was not significantly lower in the bupivacaine group. Arterial blood gases were unaffected by the treatment in both groups. It is concluded that interpleural analgesia using bupivacaine given as bolus injections at 8-h intervals significantly reduces the pain caused by a chest drain within 5 min of injection, but the duration of pain relief is less than 4 h.
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Acta Anaesthesiol Scand · Jan 1993
Randomized Controlled Trial Comparative Study Clinical TrialThe effects of prophylactic dixyrazine on postoperative vomiting after two different anaesthetic methods for squint surgery in children.
The incidence of postoperative vomiting after squint surgery was studied for two anaesthetic techniques with and without prophylactic dixyrazine. After induction, anaesthesia was maintained with either fentanyl/pancuronium/nitrous oxide or halothane/nitrous oxide in two randomly selected groups of 58 children each. Half of the children in each group were randomly allocated to receive dixyrazine 0.25 mg kg-1 i.v. after surgery had been completed but before reversal of muscle relaxants or termination of anaesthesia. ⋯ Without prophylactic dixyrazine, 20 of 29 children in the fentanyl group vomited compared to 13 of 29 in the halothane group (n.s.). Thus, prophylactic dixyrazine reduced the incidence of vomiting in children given either opioid or halothane anaesthesia for squint surgery. In comparable groups avoidance of opioid anaesthetic technique and use of prophylactic dixyrazine resulted in a greatly reduced incidence of vomiting.
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Acta Anaesthesiol Scand · Jan 1993
Randomized Controlled Trial Clinical TrialPreoxygenation techniques: the value of nitrous oxide.
Changes in arterial oxygen saturation during induction of anaesthesia and intubation were studied using the pulse oximeter. Seventy-five young ASA I patients undergoing elective uncomplicated surgery were divided equally into three groups. The patients were preoxygenated with 100% oxygen, 50% oxygen: 50% nitrous oxide or 30% oxygen: 70% nitrous oxide for 1 min. ⋯ Arterial oxygen saturations were continuously recorded by a separate investigator. All groups showed similar arterial desaturation during suxamethonium-induced apnoea and intubation, but the degree of desaturation was not clinically significant and no patient showed clinical signs of hypoxaemia. Preoxygenation with mixtures of oxygen and nitrous oxide can hasten the build-up of alveolar nitrous oxide concentration and help to smooth induction without compromising oxygenation of patients.
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Acta Anaesthesiol Scand · Jan 1993
Randomized Controlled Trial Clinical TrialAnalgesic action of metoclopramide in prosthetic hip surgery.
Prosthetic hip surgery was performed under subarachnoidal anaesthesia with bupivacaine 16-20 mg and morphine 0.2 mg. Preoperatively, metoclopramide 1 mg.kg-1 was given i.v., followed by an infusion of 1.5 mg.kg-1 over 9 h (n = 17). Control patients received corresponding volumes of solvent (n = 23. ⋯ The pain-free period was longer (P < 0.05) in the metoclopramide group. Arterial PCO2-levels were increased, reaching a maximum within 6 h of infusion, with no significant difference between the groups. The study suggests an analgesic action of metoclopramide.
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Acta Anaesthesiol Scand · Jan 1993
Randomized Controlled Trial Clinical TrialBlood pressure and heart rate during orthostatic stress and walking with continuous postoperative thoracic epidural bupivacaine/morphine.
Thirty-one patients scheduled for elective cholecystectomy performed through a mini-laparotomy, were randomized to received either combined thoracic epidural anaesthesia/light general anaesthesia and postoperative balanced analgesia with continuous epidural bupivacaine 10 mg.h-1 and morphine 0.2 mg.h-1 for 38 h after surgery plus systemic ibuprofen 600 mg x 8 h-1 (N = 15) or general anaesthesia and postoperative analgesia with systemic morphine and ibuprofen 600 mg x 8 h-1 (N = 16). During postoperative epidural infusion sensory blockade to pinprick was Th4 to L1, and analgesia at rest and during mobilisation was superior compared to systemic morphine and NSAID. ⋯ There was no significant difference between groups in number of patients with a reduction > 20 mmHg (2.7 kPa) in systolic blood pressure during orthostatic stress (two in each group at 24 h) or in number of episodes of dizziness, nausea or vomiting during rest or mobilisation. These results do not support the common belief that low-dose thoracic epidural bupivacaine/morphine may prevent ambulation due to sympathetic blockade or to impaired cardiovascular adaptation to the upright position.