British journal of anaesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparative effects of thiopentone and propofol on respiratory resistance after tracheal intubation.
To compare the effects of propofol and thiopentone on tracheal intubation-induced bronchoconstriction, 37 patients were allocated randomly to anaesthesia with either thiopentone 4 mg kg-1 followed by a 15-mg kg-1 h-1 continuous infusion or propofol 3 mg kg-1 followed by a 9-mg kg-1 h-1 continuous infusion. Intubation was facilitated by vecuronium 0.1-0.2 mg kg-1. ⋯ Thirty minutes after commencing isoflurane-nitrous oxide anaesthesia, Rrs declined by 17.5 (SEM 3.6)% from baseline in the thiopentone group, but by only 1.6 (2.6)% in the propofol group. We conclude that the dose of propofol administered provided more protection against tracheal intubation-induced bronchoconstriction than an induction dose of thiopentone.
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Clinical Trial
Propofol or halothane anaesthesia for children with asthma: effects on respiratory mechanics.
Propofol may cause histamine release and alter airway tone and reactivity. Although its use has been reported to be safe in asthmatics, there is a lack of information on its effect on lung function in children with asthma. We measured respiratory mechanics after i.v. or inhalation anaesthesia in 60 children, aged 2-12 yr, with or without asthma. ⋯ Halothane produced a minimal decrease in Rrs and a minimal increase in tidal volume in both groups without changes in Crs,dyn. In conclusion, respiratory mechanics were comparable after propofol anaesthesia in both children with and without asthma. Changes in Rrs after halothane administration were not clinically relevant.
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We set out to examine the evidence for the importance of randomization of transcutaneous electrical nerve stimulation (TENS) in acute postoperative pain. Controlled studies were sought; randomization and analgesic and adverse effect outcomes were summarized. Forty-six reports were identified by searching strategies. ⋯ Of the 29 excluded trials, 19 had pain outcomes but were not RCT; in 17 of these 19 TENS studies, the authors concluded that TENS had a positive analgesic effect. No adverse effects were reported. Non-randomized studies overestimated treatment effects.
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Clinical Trial Controlled Clinical Trial
Concentration-related effects of propofol on the auditory evoked response.
We have studied the effects of propofol, as the sole agent, at blood concentrations of 1-10 micrograms ml-1, on the first 100 ms of the auditory evoked response (AER) in 41 women before gynaecological surgery. AER were recorded with the patients awake and then after 30 min of one of seven stepped infusion regimens. Each patient was studied at only one blood concentration. ⋯ A cut-off value of 53 ms had a sensitivity of 100%, a specificity of 96% and an overall correctness of 98% as a discriminator of eyelash response vs no response. Several alternative AER-derived indices provided more than 90% correctness in discrimination, as did a dose rate of propofol of 6.3-7.8 mg kg-1 h-1 or a blood concentration of 2.9 micrograms ml-1. We conclude that the concentration and dose of propofol were good discriminators of response to venepuncture, while the latency of the Na wave was the most successful of the AER features.