Kaohsiung J Med Sci
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Kaohsiung J Med Sci · Sep 2003
Randomized Controlled Trial Clinical TrialRopivacane 0.1 % with or without fentanyl for epidural postoperative analgesia: a randomized, double-blind comparison.
Epidural analgesia is often considered optimal postoperative analgesia for certain surgical procedures. Ropivacaine is a new local anesthetic that is less toxic than its homologue, bupivacaine. Epidural infusions usually comprise a local anesthetic, an opioid, or a combination of the two to improve analgesic efficacy and reduce unwanted side effects. ⋯ However, pain relief was significantly better in the ropivacaine/fentanyl group after the first hour and this difference lasted for the remaining time. There was no significant difference in adverse events between the two groups during 24 hours of assessment. In conclusion, the quality of analgesia was significantly improved by the addition of fentanyl 1 microg/mL to ropivacaine.
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Kaohsiung J Med Sci · Jan 2002
Randomized Controlled Trial Clinical TrialThe train of four ratio decreases to zero in anesthetized children is the guide to achieve a satisfactory intubation condition.
The purpose of this study is to investigate the satisfactory (excellent or good) intubation conditions attained when the TOF ratio was zero in anesthetized children. Sixty children undergoing elective ophthalmic surgery were allocated randomly into three groups. Anesthesia was induced with thiopentone 4 mg/kg and halothane in combination with 66% N2O and O2 (2 L/min). ⋯ There is a significant difference between group 1 and group 2 and 3 (p < 0.001, group 1 vs group 2 and group 3). All children were intubated, during which procedures satisfactory intubation conditions were observed in all of the group 3 patients, in 17 of the 20 group 2, and in 16 of the 20 group 1 patients. We concluded that zero of TOF from monitoring the adductor pollicis muscle indicated the proper moment for intubation in anesthetized pediatric patients and it was a reliable guide in adequately anesthetized children to achieve satisfactory intubation conditions following 0.9 mg/kg rocuronium administration.
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Kaohsiung J Med Sci · May 2000
Randomized Controlled Trial Clinical TrialInfluences of tramadol on emergence characteristics from sevoflurane anesthesia in pediatric ambulatory surgery.
Sevoflurane is used for pediatric ambulatory surgery due to its low blood solubility, rapid emergence, non-pungency and low airway irritability. Nevertheless, its tendency to induce agitation during emergence may offset its benefits. The following study was designed to evaluate the effects of intravenous (i.v.) tramadol (1 mg/kg) on the emergence from sevoflurane anesthesia. ⋯ The emergence agitation score (6.3 +/- 3.5 vs. 3.2 +/- 2.8, P < 0.05), incidences of agitation (VAS > 5, 55% vs 20%, P < 0.05), and postoperative pain (65% vs 30%, P < 0.05) were higher for the control group. I.v. Tramadol (1 mg/kg) before the end of operation reduced postoperative pain and the incidence and degree of emergence agitation from sevoflurane anesthesia in pediatric ambulatory surgery.
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Kaohsiung J Med Sci · Sep 1999
Randomized Controlled Trial Clinical TrialTotal intravenous anesthesia using propofol and ketamine for ambulatory gynecologic laparoscopy.
Laparoscopy under total intravenous anesthesia (TIVA) with spontaneous respiration is a commonly encountered procedure in ambulatory gynecologic surgery. The purpose of this study was to evaluate the efficacy of TIVA using propofol and ketamine, compared with endotracheal inhalational general anesthesia (EIGA) for ambulatory gynecologic laparoscopy. Fifty-eight female patients, aged 17-48 years, were randomly allocated into two groups. ⋯ The incidence of intraoperative arrhythmia was higher in group 2 than in group 1 (40% vs. 3%; p < 0.001). Furthermore, the incidence of sore throat was higher in group 2 than in group 1 (47% vs. 7%; p < 0.001). We conclude that TIVA with spontaneous respiration is suitable for ambulatory gynecologic laparoscopy.
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Kaohsiung J Med Sci · Jul 1999
Randomized Controlled Trial Comparative Study Clinical TrialComparison of subcutaneous hydromorphone with intramuscular meperidine for immediate postoperative analgesia.
Intramuscular (i.m.) injection with meperidine is the most common analgesic approach to treat postoperative pain in Taiwan. Hydromorphone (Dilaudid) can provide very potent and rapid analgesic effect through subcutaneous (s.c.) injection. Although hydromorphone is widely used in North America, no study has compared the analgesic efficacy, side effect profiles and patients' satisfaction with the method of injection of hydromorphone s.c. and meperidine i.m. for the immediate post-operative analgesia. ⋯ Patients receiving hydromorphone s.c. injection exhibited higher satisfactory score than those receiving meperidine i.m. injection. Hydromorphone 1 mg, injected subcutaneously, was as effective as intramuscular meperidine 50 mg while permitting more favorable injection technique and fewer side effects. We suggest that subcutaneous hydromorphone is a good alternative to intramuscular meperidine for postoperative analgesia in the recovery room.