Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 1985
Randomized Controlled Trial Comparative Study Clinical TrialCaudal or dorsal nerve block? A comparison of two local anaesthetic techniques for postoperative analgesia following day case circumcision.
Fifty boys presenting for day case circumcision were allocated randomly to receive either caudal analgesia or dorsal nerve block (DNB) to provide postoperative pain relief. Analgesia was assessed by a single, unbiased observer utilising a three-point scale. Subsequently, parents completed a simple questionnaire. ⋯ The incidence of vomiting was significantly lower in the DNB group (P less than 0.05). There was no significant difference in the duration of analgesia, although that produced in the DNB group tended to wane sooner. It is concluded that DNB provides satisfactory analgesia following circumcision and has specific advantages when compared with caudal analgesia.
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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 · Jan 1985
Randomized Controlled Trial Comparative Study Clinical TrialPrecurarization with vecuronium and pancuronium in awake, healthy volunteers: the influence on neuromuscular transmission and pulmonary function.
The influence of pretreatment with pancuronium and vecuronium on the neuromuscular transmission was compared in 24 healthy, awake, non-premedicated volunteers using train-of-four (TOF) nerve stimulation and measurement of respiratory frequency, vital capacity, inspiratory force and peak expiratory flow (PEF). The subjects were randomly allocated to one of three groups. Each subject received one dose of pancuronium and one dose of vecuronium: Group I pancuronium 0.01 mg/kg and vecuronium 0.005 mg/kg; Group II pancuronium 0.01 mg/kg and vecuronium 0.01 mg/kg and Group III pancuronium 0.01 mg/kg and vecuronium 0.015 mg/kg intravenously. ⋯ In Group II one subject was unable to lift her head and had difficulty in swallowing following pancuronium 0.01 mg/kg. Only four subjects entered Group III because of an unacceptably high frequency of signs and symptoms of partial neuromuscular blockade and a decrease in median TOF ratio to 0.64 following vecuronium. The subjects felt it difficult to swallow, and one subject could just sustain head lift for 10 s following vecuronium 0.015 mg/kg.(ABSTRACT TRUNCATED AT 250 WORDS)
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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 · 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.