Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Aug 1986
Randomized Controlled Trial Comparative Study Clinical TrialComparison of different methods of postoperative analgesia after thoracotomy.
Fifty-one patients scheduled for thoracotomy were included in a study involving five different methods of postoperative analgesia. Forty patients were randomly divided into: Group C, receiving intramuscular oxycodone on request following an intraoperative intercostal block; Group IC, intercostal blocks with 0.5% bupivacaine performed prior to surgery, 6 h later and on the first postoperative morning: Group EB, epidural bupivacaine as a continuous infusion of 0.25% bupivacaine (5 ml h-1); Group EM4 epidural morphine 4 mg injected prior to surgery and on the first postoperative morning. In addition, a fifth group (Group EM6) of 11 patients received 6 mg of epidural morphine timed as in Group EM4, but these patients were automatically scheduled to be observed in the ICU. ⋯ Postoperative blood-gas analyses contained slightly elevated PCO2 values (6.0-7.3 kPa) in all groups. Postoperatively, only Group EB was devoid of PCO2 values above 7.3 kPa. Urinary retention was a common complication in the patients receiving epidural analgesia, occurring most frequently in Group EM6; 10 of the 11 patients had to be catheterized.
-
Acta Anaesthesiol Scand · Jul 1986
Randomized Controlled Trial Comparative Study Clinical TrialHemodynamic effects of atracurium, vecuronium and pancuronium during sufentanil anesthesia for coronary artery bypass.
A study was undertaken to evaluate the cardiovascular effects of sufentanil, in combination with three different muscle relaxants, used as sole anesthetic with 100% O2 in 30 patients undergoing elective coronary artery vein graft surgery. Patients were randomly allocated to receive pancuronium (P), vecuronium (V) or atracurium (A) for muscle relaxation. All patients received 15 micrograms/kg sufentanil at induction followed by 5-10 micrograms/kg sufentanil prior to sternotomy. ⋯ Sufentanil in combination with pancuronium or vecuronium provided stable hemodynamic conditions throughout anesthesia. Atracurium was less satisfactory. We conclude that there is no advantage to be gained, in the presence of beta blockade, from the use of the new generation muscle relaxants as compared to pancuronium during high-dose sufentanil anesthesia for coronary artery vein grafting.
-
Acta Anaesthesiol Scand · May 1986
Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical TrialGlycopyrrolate during ketamine/diazepam anaesthesia. A double-blind comparison with atropine.
In a double-blind study, the effects of atropine and glycopyrrolate (dosage ratio 2:1) following i.m. and i.v. administration were compared with respect to salivation, heart rate, and blood pressure before, during and after i.v. infusion anaesthesia with ketamine and diazepam for alloplastic hip or knee surgery in 30 patients above the age of 50 years. Given with the premedicant, the two drugs were equally effective in reducing salivation. ⋯ A second dose of the test drug was given with neostigmine for reversal of neuromuscular blockade. Again, there were no statistically significant differences with respect to salivation, blood pressure, heart rate, nausea and/or vomiting, unpleasant dreams and arousal time.
-
Acta Anaesthesiol Scand · May 1986
Randomized Controlled Trial Clinical TrialPrevention of peroperative hypothermia in abdominal surgery.
It is important to reduce or prevent heat loss during anaesthesia, especially in patients with restricted cardiopulmonary reserves. To test a specially developed esophageal thermal tube (GK-esophageal thermal tube) for this purpose, 33 patients were randomly divided into two groups: Group A were given heat transferred to the central core during operation, using the GK-tube with circulating 41.7 degrees C warm water. Group B received no active warming. ⋯ The described method was easy to use and without complications. We recommend this method to prevent peroperative hypothermia in all patients suspected to have limited cardiopulmonary reserves. The possible hazards and how to avoid these are described.
-
Acta Anaesthesiol Scand · Apr 1986
Randomized Controlled Trial Clinical TrialComparative effects of intrathecal bupivacaine and tetracaine on analgesia, cardiovascular function and plasma catecholamines.
Forty otherwise healthy male patients, scheduled for elective inguinal herniotomy, were randomly allocated to spinal anaesthesia with 3 ml 0.5% hyperbaric tetracaine or bupivacaine under double-blind conditions. The extent of blockade (pin-prick and cold sensation), blood pressure and heart rate and plasma catecholamines were measured before and 5, 10, 15, 20 and 30 min after injection, before skin incision. Cephalad spread of sensory and temperature analgesia was insignificantly higher after tetracaine. ⋯ Plasma norepinephrine and epinephrine measurements before spinal puncture and at maximal decrease in mean arterial pressure showed a depressed response to fall in blood pressure in the tetracaine group. It is concluded that spinal anaesthesia with 3 ml hyperbaric 0.5% tetracaine is followed by a more pronounced fall in blood pressure compared to an identical dose of bupivacaine. The more pronounced sympathetic blockade, confirmed by plasma catecholamine measurements, following tetracaine is probably due to a higher cephalad spread of neurogenic blockade, rather than a differential effect on sympathetic nerve fibres.