Anaesthesia
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Randomized Controlled Trial Clinical Trial
The cardiovascular responses to double lumen endobronchial intubation and the effect of esmolol.
The cardiovascular responses to double lumen endobronchial intubation and the effect of esmolol were examined in two groups of 10 ASA 2 & 3 patients undergoing pulmonary surgery in a double blind, placebo-controlled study. Endobronchial intubation was associated with a significant increase in arterial pressure and heart rate (p = 0.004), and a significant increase in plasma noradrenaline concentrations (p < 0.01) in the control group. ⋯ The increase in plasma noradrenaline concentrations was significantly greater (p < 0.05) in the esmolol group. The pressor response to endobronchial intubation in this study was of a similar magnitude to that known to occur in response to tracheal intubation.
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Randomized Controlled Trial Clinical Trial
Dreams, images and emotions associated with propofol anaesthesia.
One hundred and twelve patients scheduled for day case varicose vein surgery were randomly allocated to one of three groups: total intravenous anaesthesia with propofol, propofol induction followed by inhalational anaesthesia with nitrous oxide and isoflurane or thiopentone induction followed by inhalational anaesthesia with nitrous oxide and isoflurane. Assessments were made in the recovery room of the incidence of dreaming, the content of the dreams and the emotional status of the patients. ⋯ However, despite the large number of case reports of sexual imagery following propofol anaesthesia and despite the two groups who had received propofol experiencing significantly greater happiness upon recovery than the thiopentone group, there were no appreciable differences in the sexual content of the dreams. Each group had only a small number of dreams even remotely related to sex.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of the nasal mask and the nasopharyngeal airway in paediatric chair dental anaesthesia.
This study compared the quality of anaesthesia and surgical access afforded by two techniques for the administration of anaesthesia during paediatric chair dental procedures. A total of 50 ASA 1 paediatric day case patients were randomly assigned to receive anaesthesia through either the traditional Goldman nasal mask or through a nasopharyngeal airway. ⋯ Operating conditions were universally graded as excellent in the nasopharyngeal airway group, while those in the nasal mask group were graded as excellent/good in only 79% of cases (p < 0.0001). These results suggest that better quality anaesthesia and operating conditions can be achieved by using a nasopharyngeal airway rather than the traditional nasal mask for the administration of anaesthesia to paediatric chair dental patients.
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Randomized Controlled Trial Clinical Trial
Effects of a single pre-operative dexmedetomidine dose on isoflurane requirements and peri-operative haemodynamic stability.
In a double-blind, placebo-controlled study we investigated the effect of a single pre-induction intravenous dose of dexmedetomidine 2 micrograms.kg-1 on anaesthetic requirements and peri-operative haemodynamic stability in 50 patients undergoing minor orthopaedic and general surgery. Patients were anaesthetised with nitrous oxide/oxygen/fentanyl, supplemented if necessary with isoflurane. ⋯ The haemodynamic response to tracheal intubation and extubation was reduced in the dexmedetomidine group as was intra-operative heart rate variability; postoperative analgesic and anti-emetic requirements and peri-operative serum catecholamine concentrations were lower in the dexmedetomidine group. Hypotension and bradycardia occurred more frequently after dexmedetomidine.
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Randomized Controlled Trial Comparative Study Clinical Trial
Intra-ocular pressure changes following laryngeal mask airway insertion: a comparative study.
We compared the effects of the Brain laryngeal mask airway with a tracheal tube on intra-ocular pressure. Propofol was used as induction agent and atracurium as relaxant. Twenty-six patients with normal intra-ocular pressure undergoing cataract surgery were randomly allocated to two groups. ⋯ In the laryngeal mask airway group there were no significant changes in mean intra-ocular pressure. In the tracheal tube group there was a significant rise in mean intra-ocular pressure at 20 s (p = 0.0056) which returned to pre-insertion levels at 2 min. We conclude that the laryngeal mask airway continues to have advantages over the tracheal tube for ophthalmic surgery despite the use of propofol and atracurium as anaesthetic agents.