Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1997
Randomized Controlled Trial Comparative Study Clinical TrialComparison of continuous epidural infusion of fentanyl and bupivacaine with intermittent epidural administration of morphine for postoperative pain management in children.
The aim of this study was to compare epidural infusion of bupivacaine and fentanyl and intermittent epidural morphine with regard to analgesic effect, and incidence and severity of side effects in children undergoing major abdominal or genito-urological surgery in order to improve the postoperative pain management of children. ⋯ Continuous epidural infusion of fentanyl and bupivacaine was found to be superior to intermittent epidural morphine. The initial regimen should be fentanyl 2 micrograms/ml and bupivacaine 1.0 mg/ml infused at a rate of 0.25 ml.kg-1.h-1.
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Acta Anaesthesiol Scand · Apr 1997
Randomized Controlled Trial Clinical TrialTramadol in the treatment of postanesthetic shivering.
As an inhibitor of the reuptake of serotonin and norepinephrine in the spinal cord, the mechanism of action of tramadol resembles that of nefopam, which has been used in the treatment of postanesthetic shivering. ⋯ Tramadol's distinct features in the treatment of shivering reside in its high safety profile and weak sedative properties, particularly in patients with poor cardiorespiratory reserve, in outpatients and on recurrence of shivering.
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Acta Anaesthesiol Scand · Apr 1997
Randomized Controlled Trial Clinical TrialNitrous oxide has different effects on the EEG and somatosensory evoked potentials during isoflurane anaesthesia in patients.
Electroencephalogram (EEG) and somatosensory evoked potentials (SEPs) are altered by inhalation anaesthesia. Nitrous oxide is commonly used in combination with volatile anaesthetics. We have studied the effects of nitrous oxide on both EEG and SEPs simultaneously during isoflurane burst-suppression anaesthesia. ⋯ The results suggest that during isoflurane anaesthesia, nitrous oxide has a different effect on EEG and cortical SEP at the same time. The effects of nitrous oxide may be mediated by cortical and subcortical generators.
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Acta Anaesthesiol Scand · Apr 1997
Randomized Controlled Trial Clinical TrialThe haemodynamic effects of rocuronium and vecuronium are different under balanced anaesthesia.
Rocuronium has been reported to have minimal haemodynamic effects. However, this conclusion has been drawn primarily from investigations conducted under narcotic-based anaesthesia. This study was designed to evaluate the cardiovascular effects of rocuronium under isoflurane/N2O/fentanyl anaesthesia and to compare rocuronium's haemodynamic effects to those of vecuronium and pancuronium. ⋯ The haemodynamic effects of rocuronium and vecuronium are different under balanced anaesthesia. Rocuronium may attenuate the fall in MAP that often occurs under balanced anaesthesia without surgical stimulation.
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Acta Anaesthesiol Scand · Apr 1997
Case ReportsSevere complications associated with epidural and spinal anaesthesias in Finland 1987-1993. A study based on patient insurance claims [see comment].
The Patient Injury Act has been in effect in Finland since 1 May 1987. This legislation is a no-fault compensation scheme and implies that if a patient during the course of medical treatment suffers any injury as a result of that treatment he or she may file a claim to the Patient Insurance Association (PIA). From 1 May 1987 to 31 December 1993, 23,500 claims for compensation were made. ⋯ According to this material the incidence of serious complications was 0.45:10,000 following spinal and 0.52:10,000 following epidural anaesthesia. Atraumatic technique, careful patient selection and early diagnosis and treatment of complications are essential in avoiding permanent injury.