Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 2000
Randomized Controlled Trial Comparative Study Clinical TrialAnaesthesia, recovery and postoperative nausea and vomiting after breast surgery. A comparison between desflurane, sevoflurane and isoflurane anaesthesia.
Whereas induction and recovery will occur more rapidly with the new low soluble anaesthetics than with isoflurane, the quality of anaesthesia and recovery with special emphasis on postoperative nausea and vomiting (PONV) is not well known. ⋯ The quality of anaesthesia, time to opening of eyes and influence on respiration was similar with all three anaesthetics. As the emergence from anaesthesia did not differ significantly between the three agents, the choice of agent could be based on PONV rate and price. Desflurane had a significantly higher 24 h PONV rate than isoflurane. Early PACU PONV rate was significantly (P<0.05) lower for the more soluble isoflurane (4%) than for the low soluble gases, desflurane and sevoflurane together (28%). The result of this study does not give a rationale for a transition to the new low soluble agents in breast cancer surgery.
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Acta Anaesthesiol Scand · Apr 2000
Randomized Controlled Trial Comparative Study Clinical TrialThe effect of sedation on weaning following coronary artery bypass grafting: propofol versus oxycodone-thiopental.
Propofol has been advocated for sedation in intensive care because of superior recovery characteristics. We hypothesised that the use of two totally different sedation methods after coronary artery bypass grafting should result in differences not only in extubation time, but also in breathing pattern and gas exchange during weaning and after extubation. ⋯ Propofol infusion and oxycodone-thiopental bolus dosages, titrated to the same sedation end point, resulted in similar time from admission to extubation, although the weaning period was shorter in the propofol group. In terms of breathing pattern, gas exchange, blood gases and haemodynamics, the methods were similar. Propofol, despite its attractive pharmacological profile, may offer no clinical benefit in short-term sedation after a moderate dose fentanyl anaesthesia in cardiac surgery.
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Acta Anaesthesiol Scand · Apr 2000
Randomized Controlled Trial Comparative Study Clinical TrialTracheal intubation without the use of muscle relaxants: remifentanil or alfentanil in combination with propofol.
Alfentanil-propofol combination provides adequate conditions for tracheal intubation without neuromuscular blocking drugs in most patients. Providing an option for intense opioid effect without compromising recovery after short operations, remifentanil might offer benefits over alfentanil, especially in ambulatory surgery. In this study intubating conditions after remifentanil-propofol were compared to those after alfentanil-propofol. ⋯ The best method was the combination of remifentanil 4 microg kg(-1) and propofol 2.5 mg kg(-1). This provided satisfactory intubating conditions in 93%, and prevented cardiovascular intubation response.
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Acta Anaesthesiol Scand · Apr 2000
Randomized Controlled Trial Comparative Study Clinical TrialComparison of hypotensive epidural anaesthesia and spinal anaesthesia on blood loss and coagulation during and after total hip arthroplasty.
Hypotensive epidural anaesthesia (HEA) is a technique for reducing peroperative blood loss by significantly lowering mean arterial pressure (MAP). ⋯ HEA resulted in reduced blood loss due to hypotension and reduced number of transfused PRC units during total hip arthroplasty. Based on lower prothrombin time value and higher D-dimer concentrations in the SPA group, the coagulation system might be better preserved during HEA than SPA.