Der Anaesthesist
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Randomized Controlled Trial Comparative Study Clinical Trial
[Postoperative analgesia with tramadol and metamizol. Continual infusion versus patient controlled analgesia].
The study compares the i.v. analgesia of tramadol and dipyrone delivered either as continuous infusion or as patient controlled analgesia (PCA). ⋯ PCA with tramadol and dipyrone can be considered an alternative for postoperative pain management and provided a more individualized treatment approach with lower analgesic consumption and more responders compared to a continuous infusion.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Anaesthesia for caesarean section. Comparison of two general anaesthetic regimens and spinal anaesthesia].
The study was undertaken to compare different anaesthetic techniques for scheduled or urgent caesarean section with respect to maternal circulatory parameters, maternal and fetal endocrine stress response, fetal vitality parameters and further clinical parameters such as recovery and analgesic demand. ⋯ When compared with methohexitone, sevoflurane and N(2)O for caesarean section, initial total intravenous anaesthesia with esketamine and methohexitone mediated specific antinociception without negative maternal or fetal effects and not taking invasion kinetics or elimination between uterotomia and cord cutting into consideration. Avoidance of N(2)O allows optimal oxygenation of the fetomaternal unit. Stress protection and hemodynamic responses were well balanced, and intraoperative recall or negative dream reactions were lacking. Superior postoperative pain protection was advantageous after spinal anaesthesia, but in contrast, nausea and vomiting were more frequent in this group.
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Randomized Controlled Trial Clinical Trial
[Narcotrend EEG monitoring during total intravenous anaesthesia in 4.630 patients].
The Narcotrend is a new EEG monitor designed to measure the hypnotic component of anaesthesia; however, a major clinical evaluation is still missing. This prospective multicentre study was designed to investigate the feasibility of Narcotrend monitoring in a large number of patients under different clinical conditions and to define its impact on recovery times after propofol-based total intravenous anaesthesia. ⋯ The EEG monitor Narcotrend can be used for adult patients of different ages and during various surgical procedures.Narcotrend monitoring facilitates a reduction of recovery times after propofol-based total intravenous anaesthesia,presumably by allowing for an individual titration of the propofol dosage. Moreover, it appears that the profile of recovery can be optimised when at the end of surgery,the propofol infusion is controlled to Narcotrend stage C instead of D, E, or F.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Recovery from anaesthesia and incidence and intensity of postoperative nausea and vomiting following a total intravenous anaesthesia (TIVA) with S-(+)-ketamine/propofol compared to alfentanil/propofol].
Opioids contribute to postoperative nausea and vomiting (PONV). An intraoperative analgesia with S-(+)-ketamine will make opioid administration dispensable and may reduce postoperative analgesic requirements. The aim of the study was to record the incidence and intensity of PONV following a total intravenous anesthesia (TIVA) with S-(+)-ketamine/propofol (K/P) or alfentanil/propofol (A/P) as well as recovery from anaesthesia. ⋯ A TIVA with K/P did not reduce PONV when compared to A/P, but prolonged recovery.
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Randomized Controlled Trial Clinical Trial
[Precurarization of succinylcholine with cisatracurium: the influence of the precurarization interval].
To determine the influence of two different pretreatment intervals, i.e. 3 and 6 min, on the efficacy of 0.01 mg/kg cisatracurium in preventing succinylcholine-induced fasciculations and myalgia. ⋯ Cisatracurium is only effective in preventing succinylcholine-induced fasciculations when a longer pretreatment interval, i.e. 6 min instead of 3 min, is chosen. Precurarization led to signs of paralysis in both pretreatment groups in the majority (75-80%) of patients without reducing the incidence or severity of postoperative myalgia.