Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 1985
Randomized Controlled Trial Comparative Study Clinical TrialEffects of three anaesthesia methods on haemodynamic responses connected with the use of thigh tourniquet in orthopaedic patients.
Haemodynamic changes were studied in 51 patients undergoing orthopaedic surgery of the lower extremity, including exsanguination and thigh tourniquet for longer than 60 min. The patients were randomly divided into three anaesthesia groups: general anaesthesia (including enflurane), epidural anaesthesia (20 ml 0.5% bupivacaine) and spinal anaesthesia (3 ml 0.5% bupivacaine). During the study, five epidural and one spinal patient excluded from haemodynamic comparison required general anaesthesia because of pain from the surgery or ischaemia. ⋯ On the other hand, 11/15 of the epidural patients needed additional analgesics and/or sedation for pain or restlessness. The mean rise in the haemodynamic parameters including CVP was small on inflation of the tourniquet cuff; on deflation there was a mean decrease in CVP of 1-3 cmH2 (0.1-0.3 kPa), the maximum decrease being 8 cmH2O (0.8 kPa). The mean decrease in systolic arterial blood pressure ranged from 2 to 14 mmHg (0.27 to 1.87 kPa) when the cuff was deflated.
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Acta Anaesthesiol Scand · Dec 1984
Randomized Controlled Trial Comparative Study Clinical TrialPerivascular axillary block V: blockade following 60 ml of mepivacaine 1% injected as a bolus or as 30 + 30 ml with a 20-min interval.
Perivascular axillary blockade was performed on 60 patients with the aid of a catheter technique. The patients were randomly allocated to two groups. All patients received the same dose of local anaesthetic: 60 ml of mepivacaine 1% with adrenaline, but one group received the dose as a bolus injection, whereas the other group received the dose as fractional injections of 30 + 30 ml with an interval of 20 min. ⋯ There was no difference in blood concentrations of mepivacaine between the two groups. None of the 60 patients showed any sign of systemic toxic reactions. Fractional injection of local anaesthetic in perivascular axillary blockade does not offer any advantage over bolus injection with regard to the resulting blockade.
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Acta Anaesthesiol Scand · Dec 1984
Randomized Controlled Trial Comparative Study Clinical TrialComparison of intramuscular analgesia, intercostal block, epidural morphine and on-demand-i.v.-fentanyl in the control of pain after upper abdominal surgery.
Eighty patients undergoing upper abdominal surgery were randomly allocated to four groups according to the postoperative pain treatment. All patients had a standardized balanced anaesthesia and for postoperative analgesia either intramuscular oxycodone and/or metamizol (IM), intercostal block with 0.5% bupivacaine (IC), epidurally 4 mg morphine (EM) or i.v. infusion of fentanyl 0.54-0.99 micrograms min-1 + on-demand boluses of 7.2-13.5 micrograms (ODAC) were given. The pain intensity 2 h postoperatively was similar in all groups, mean score ranging from 3.2-4.3 on a scale from 0-10. ⋯ The amount of fentanyl infused in 24 h to the ODAC patients varied considerably, 814-2233 micrograms, as did the number of on-demand boluses, 3-155. At 24 h, an efficacy rating "good" was distributed as follows: IM 9/20, IC 11/20, EM 11/20 and ODAC 13/20. In the whole patient material 92.5% rated their condition as "good" or "fair".
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Acta Anaesthesiol Scand · Oct 1984
Randomized Controlled Trial Clinical TrialHypotensive anesthesia, thromboprophylaxis and postoperative thromboembolism in total hip arthroplasty.
A prospective study was performed in 120 patients undergoing total hip arthroplasty. The patients were randomly allocated to four groups. The first two groups had nitroprusside-induced hypotensive anesthesia with either a fixed combination of sodium heparin and dihydroergotamine mesylate (HDHE) or dextran 70. ⋯ There was a lower incidence of pulmonary embolism in patients with HDHE and normotensive anesthesia. Major wound hematomas were noted postoperatively in 12% of the patients receiving HDHE, whereas no major hematomas developed following dextran prophylaxis. No anaphylactic reaction was noted from dextran 70, using hapten-dextran prophylaxis.
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Acta Anaesthesiol Scand · Aug 1984
Randomized Controlled Trial Comparative Study Clinical TrialEnflurane, isoflurane and the eye.
The intra-ocular pressure was monitored in ophthalmological patients in whom nitrous oxide/oxygen anaesthesia was supplemented with an inspired concentration of 1% enflurane (10 patients) or 0.7% isoflurane (10 patients). These concentrations are proportionate to 0.6 MAC in oxygen. ⋯ There was no significant difference between agents. Isoflurane offers an alternative to enflurane in surgery when intra-ocular pressure is of importance.