Der Anaesthesist
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Randomized Controlled Trial Clinical Trial
[Lung compliance in man is impaired by the rapid injection of alfentanyl].
To demonstrate opioid-induced muscular rigidity, compliance was measured in patients after induction of anaesthesia with etomidate (0.3 mg/kg) and N2O/O2 (2:1) ventilation. Alfentanil was given subsequently to two groups of patients: either as a bolus injection (n = 15) over 3 s, or as a slow injection (n = 15) over 30 s. Significant reduction of compliance (max. 30%) was observed after rapid injection in the following 4 min. ⋯ The slow injection of the opioid over 30 s, was followed by a small insignificant reduction in compliance. Alfentanil is increasingly used for short-term anaesthesia where no muscle relaxants are administered. Thus slow injection of the opioid is advised in order not to impair adequate ventilation.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Propofol in comparison with etomidate for the induction of anesthesia].
In the present study propofol and etomidate were compared with respect to the effects on the cardiovascular system and its side effects in 100 patients ASA grade I-IV. Anaesthesia was induced with 2.2 mg kg-1 body weight propofol. Supplemented with opioids and benzodiazepins the dose diminished to 1.8 mg kg-1 body weight (18.2%). ⋯ Pain on injection was frequent but thrombosis and phlebitis were not observed. There was a considerably lower incidence of postoperative nausea and vomiting compared with etomidate. The investigators concluded: propofol can be recommended for induction of anaesthesia as an alternative to etomidate.