Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 1990
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the effects of fentanyl on respiratory mechanics under propofol or thiopental anaesthesia.
Twenty patients were randomly anaesthetized with either thiopental 5 mg/kg followed by a 15 mg/kg/h continuous infusion, or propofol 2.5 mg/kg followed by a 9 mg/kg/h continuous infusion, paralysed with vecuronium 0.1 mg/kg, intubated and ventilated with nitrous oxide 50% in oxygen. Fifteen minutes after induction, fentanyl 5 micrograms/kg was injected. Inspiratory tracheal pressure (PT), gas flow (V) and volume (V) were continuously measured while the lungs were inflated with a constant inspiratory flow ventilator. ⋯ In both groups Crs decreased following anaesthesia. Fentanyl injection elicited an increase in Rrs (from 1.04 +/- 0.70 to 1.63 +/- 0.92 kPa x l-1 x s) and a further decrease in Crs (from 0.55 +/- 0.30 to 0.42 +/- 0.10 l x kPa-1) in the thiopental group but not in the propofol group (Rrs: 1.26 +/- 0.69 to 1.08 +/- 0.44 kPa x l-1 x s, Crs: 0.49 +/- 0.11 to 0.48 +/- 0.13 l x kPa-1). These results suggest that the dose of propofol administered in this study may prevent fentanyl-induced bronchoconstriction.
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Acta Anaesthesiol Scand · Apr 1990
Randomized Controlled Trial Comparative Study Clinical TrialPostoperative emesis after pediatric strabismus surgery: the effect of dixyrazine compared to droperidol.
Sixty-one children, ASA physical status I, aged 2-14 years, admitted for strabismus surgery were studied. All were premedicated with diazepam and atropin rectally. Anesthesia was induced with thiopental or with halothane on a facemask, and succinylcholine was given to facilitate tracheal intubation. ⋯ The incidence of vomiting during the following 24 h was 65% in the control group, 48% in the droperidol group, and 25% in the dixyrazine group (P less than 0.05 as compared to the control group). Four hours after the operation, six children in the droperidol group and none in the dixyrazine group (P less than 0.05) were difficult to arouse. It is concluded that dixyrazine reduces the incidence of postoperative vomiting without causing heavy sedation.
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Acta Anaesthesiol Scand · Apr 1990
Randomized Controlled Trial Clinical Trial Controlled Clinical TrialThe experience of the person ventilating the lungs does influence postoperative nausea and vomiting.
One hundred and ninety-eight patients undergoing elective abdominal hysterectomy were anaesthetized with isoflurane in nitrous oxide and oxygen. Ventilation before endotracheal intubation was carried out either by an experienced senior or by an inexperienced junior member of the anaesthetic team. ⋯ Patients whose lungs had been ventilated by experienced members of staff had significantly less (P less than 0.05 to 0.01) postoperative emesis in the recovery room (incidence of emesis 35%) and 2-6 h after operation (incidence 27%) when compared to patients whose lungs had been ventilated by inexperienced members of staff (incidence of emesis 54% and 40% in the recovery room and after 2 to 6 h, respectively). The results suggest that the experience of the person ventilating the lungs is associated with postoperative nausea and vomiting.
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Acta Anaesthesiol Scand · Apr 1990
Randomized Controlled Trial Clinical TrialPredictable PaCO2 with two different flow settings using the Mapleson D system.
Two different settings of fresh gas flow (VFG) and minute ventilation (VE) used with the coaxial Mapleson D system (Bain), were evaluated in 59 adults (ASA I-III) during controlled ventilation and different types of surgical procedures. The two flow settings (alternatives A and B) were VFG of 75 and 110 ml.min-1.kg-1 and VE of 150 and 175 ml.min-1.kg-1, aiming to generate normocapnea and mild hypocapnea, respectively. ⋯ With alternative B, the PaCO2 was 4.4 +/- 0.5 kPa, with 82% of the patients within the range 3.5-4.9 kPa. It is concluded that these two flow regimes are suitable for clinical use when either normocapnea or mild hypocapnea is desired.
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Acta Anaesthesiol Scand · Feb 1990
Randomized Controlled Trial Comparative Study Clinical TrialVisceral pain during caesarean section under spinal and epidural anaesthesia with bupivacaine.
In a randomized study, the incidence of visceral pain was evaluated in 46 patients undergoing elective caesarean section under spinal or epidural anaesthesia with 0.5% bupivacaine. If the patient experienced pain during the operation, a standard visual analogue scale ranging from 0 to 10 was used to assess the degree of pain. Visceral pain occurred in 12/23 patients in the spinal group and in 13/23 patients in the epidural group. In neither group was a correlation found between the cephalad level of analgesia or the intensity of cutaneous analgesia in the sacral region, and the presence of visceral pain.