Minerva anestesiologica
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Minerva anestesiologica · Mar 1994
Randomized Controlled Trial Comparative Study Clinical Trial[Trazodone versus flunitrazepam in premedication in day-care surgery].
A prospective single-blind study was conducted to compare flunitrazepam vs trazodone in the premedication of patients undergoing day-case surgery for termination of pregnancy, with particular regard to the degree of preoperative sedation, intraoperative analgesia and postoperative recovery. 86 patients were randomly allocated to receive orally 45 minutes before the surgical procedure either flunitrazepam 2 mg (group F) or trazodone 50 mg (group T). In both groups anaesthesia was achieved by i.v. fentanyl 2.5 micrograms/kg and ketamina 250 micrograms/kg. Patients in group F showed a deeper degree of preoperative sedation. ⋯ In the postoperative period, the incidences of emetic symptoms and dizziness were similar in both groups; the incidence of drowsiness was significantly higher in group F at 120 minutes but not at 180 minutes of observation. Psychomotor performance was assessed preoperatively two days before the surgical procedure and 60, 120 and 180 minutes after surgery, using the Toulouse-Pieron test and the reaction time to a luminous stimulus with the aid of a computerized analogic tachystoscope (Neurometer). Trazodone allowed a more rapid recovery of psychomotor performance and it can represent a valid alternative to the use of benzodiazepines in the premedication of day-case surgical patients.
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Minerva anestesiologica · Mar 1994
Randomized Controlled Trial Comparative Study Clinical Trial[Clinical and neuropsychologic evaluation of different anesthesia techniques (propofol vs isoflurane) in general surgery].
Different anaesthetic techniques in the perioperative period (induction and maintenance of anesthesia, recovery and 48 postoperative hours) were evaluated in 200 patients undergoing general surgery. After randomization, results from 4 groups, were clinically and statistically compared according to the anesthetic techniques performed (propofol + fentanyl in air/O2; isoflurane + fentanyl in air/O2; propofol + fentanyl in N2O/O2; isoflurane in N2O/O2). The results show that anesthesia without N2O is difficult and fentanyl isn't the ideal analgesic; but no difference was found between the anesthetic techniques in quality of induction and maintenance, speed of recovery and quality of postoperative period.
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Minerva anestesiologica · Oct 1993
Randomized Controlled Trial Comparative Study Clinical Trial[Postoperative intravenous analgesia].
The authors report the results of two clinical studies on postoperative pain relief with PCA. In the first clinical study 44 patients, undergoing gynecologic surgery, were assigned at random to two groups. The first was treated by PCA (infusor Baxter) with morphine i.v. (basal bolus 0.05 mg/kg, loading doses 1 mg every 6-15'), the second with 10 mg morphine i.m. at the end of surgery and then on demand with a lock-out of 6h at least. ⋯ Patients and nurses agree PCA. Nursing staff expressed a positive opinion and patients said they benefitted from PCA. As reported, PCA appears from our results, valid and safe in postoperative pain relief.
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Minerva anestesiologica · Jun 1993
Randomized Controlled Trial Comparative Study Clinical Trial[Combined anesthesia (epidural-general) in thoracic surgery: the cardiocirculatory response to induction. Propofol vs midazolam plus alfentanil].
Thoracic epidural block may unpredictably blunt the physiological sympathetic response to anaesthetic agents and profound hypotension could result at induction time. The authors evaluate two different induction regimens in 16 patients scheduled for major thoracic surgery in order to assess which of them would produce less hemodynamic changes. After the institution of high thoracic epidural block (6 ml lidocaine-CO2 2% + epinephrine 1/200,000 level: th.2-3), patients were randomly allocated in two induction groups: P and M. ⋯ In P group the fall in blood pressure is more pronounced than M group (p < 0.05). Noteworthy in both groups cardiac frequency do not increase and in M group significantly lowers. In the authors view the midazolam plus alfentanil induction technique compare well with propofol alone and would recommend its use in poor risk patients.
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Minerva anestesiologica · Jun 1993
Randomized Controlled Trial Comparative Study Clinical Trial[The treatment of postoperative shivering with nefopam hydrochloride].
After having considered the physiopathological mechanism of shivering, the authors have estimated in a randomised study the effects of the resolution of shivering by nefopam hydrochloride. This drug a dose of 0.20 mg/kg resolved the symptoms in 100% of cases and the placebo hasn't resolved a case so that case it also obtained the same effects. The authors have proved the efficacy of the nefopam hydrochloride in the control of postoperative shivering in the recommended dose.