Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Jan 1991
Randomized Controlled Trial Clinical TrialInjection pain, intubating conditions and cardiovascular changes following induction of anaesthesia with propofol alone or in combination with alfentanil.
In a double-blind study, propofol (P) 2-2.5 mg.kg-1 preceded by saline (Sal) or alfentanil (A) 20-30 micrograms.kg-1 was used for anaesthetic induction in 59 young patients of ASA physical class I or II, premedicated with oxycodone 0.1 mg.kg-1 and atropine 0.01 mg.kg-1 i.m. The patients were randomly allocated to one of the four groups: Group 1 Sal + P2.5, Group 2 A20 + P2.5, Group 3 A30 + P2.5 and Group 4 A30 + P2. Pain on injection of propofol occurred in 67, 36 and 7% of the patients in the Sal + P2.5, A20 + P2.5 and A30 + P2 groups, respectively, but not at all in the A30 + P2.5 group. ⋯ The other groups did not differ significantly from the Sal + P2.5 group. After injection of propofol, both systolic and diastolic arterial pressures decreased significantly in all other groups, with the exception of diastolic pressure in the Sal + P2.5 group, whereas heart rate did not differ from the control level. After intubation, systolic arterial pressure increased statistically significantly in the Sal + P2.5 and A30 + P2 groups and diastolic arterial pressure in all other groups with the exception of the A30 + P2.5 group when compared with the corresponding preceding values.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Acta Anaesthesiol Scand · Jan 1991
Randomized Controlled Trial Comparative Study Clinical TrialTransnasal butorphanol: a new method for pain relief in post-cesarean section pain.
This study was undertaken to evaluate the efficacy and the safety of transnasal butorphanol (TNB) compared to intravenous butorphanol (IVB) in 186 patients experiencing moderate to severe post-cesarean section pain. Patients were randomly assigned to five groups in a double-blind fashion: Group I (n = 37) received 2 mg IVB, Group II (n = 38) 2 mg TNB, Group III (n = 36) 1 mg TNB followed by a repeat dose of 1 mg TNB at 60 min, Group IV (n = 38) 0.5 mg TNB followed by a repeat dose of 0.5 mg at 60 min, and Group V (n = 37) received placebo. All administrations were double dummy. ⋯ There were no incidences of nasal mucosa irritation, or cardiovascular or respiratory depression. It is concluded that transnasal butorphanol represents a safe and effective alternative to injectable butorphanol for post-cesarean section pain and offers a better and longer duration of analgesia compared to IV butorphanol. The optimum dose seems to be 2 mg TN butorphanol and it is tolerated better when divided into 1 mg increments, given 1 h apart.
-
Acta Anaesthesiol Scand · Nov 1990
Randomized Controlled Trial Clinical Trial Controlled Clinical TrialEffect of epidurally administered bupivacaine on atracurium-induced neuromuscular blockade.
The effect of epidurally administered bupivacaine on duration, intensity and reversal characteristics of atracurium-induced neuromuscular blockade was studied in 30 healthy patients anaesthetized with thiopentone, fentanyl, midazolam and nitrous oxide. Fifteen patients received, in addition, epidural anaesthesia with bupivacaine. The remaining patients served as controls. ⋯ Post-tetanic count (PTC) after 20 min was also significantly lower in the epidural group (P less than 0.05). It is therefore concluded that epidurally administered bupivacaine prolongs atracurium-induced neuromuscular blockade. The clinical implication of the modest prolongation is, however, limited.
-
Acta Anaesthesiol Scand · Nov 1990
Randomized Controlled Trial Clinical TrialClonidine premedication: a useful adjunct in producing deliberate hypotension.
The effect of clonidine on the dose requirements of labetalol and isoflurane for hypotension was studied in 20 adult patients undergoing middle-ear surgery. Group I (10 patients) received as premedication only pethidine 1 mg.kg-1 i.m., and Group II (10 patients) clonidine 4-5 micrograms.kg-1 p.o. in addition to pethidine. Fentanyl was used for analgesia and d-tubocurarine for muscle relaxation. ⋯ Urine flow rates (UF) were lower in Group II (0.23 +/- 0.04 ml.min-1) than in Group I (0.68 +/- 0.16 ml.min-1) before hypotension (P less than 0.05) and during hypotension (0.08 +/- 0.02 ml.min-1 vs. 0.68 +/- 0.32 ml.min-1, P less than 0.05). After anaesthesia, there was no difference in UF between the groups. The results indicate that clonidine can be used for deliberate hypotension to decrease the dose requirements of labetalol and isoflurane.
-
Acta Anaesthesiol Scand · Oct 1990
Randomized Controlled Trial Clinical TrialHeat and moisture exchangers and the body temperature: a peroperative study.
The importance of conditioning the inhaled gas for maintaining the body temperature during artificial respiration was investigated. The mean body temperature (MBT) was deduced from readings from five measuring sites, four of which were situated at the skin and the fifth in the rectum. Temperature recordings were made every 15th min. ⋯ Our finding correlated fairly well with a predicted reduction of heat loss of 26.0 kJ/h for the type of HME used. A certain margin of error seemed to be inevitable in measuring body temperatures, and the reason for this is discussed. Our results support the fact that the investigation is adequately designed, and that the heat conserved with an HME is rather low.