Masui. The Japanese journal of anesthesiology
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Randomized Controlled Trial Clinical Trial
[Effects of oral alpha 2 adrenergic agonists, clonidine and tizanidine, on tetracaine spinal anesthesia].
This study was conducted to evaluate the effects of oral clonidine and tizanidine, alpha 2 adrenergic agonists, as premedication for tetracaine spinal anesthesia in 63 gynecological patients. The patients were randomly allocated to one of six groups. Group 1 (n = 7), group 2 (n = 8) and group 3 (n = 7) received 13 mg of tetracaine intrathecally in 10 % glucose solution 2.6 ml. ⋯ Heart rate and systolic blood pressure in group 6 (clonidine-tetracaine-phenylephrine group) showed significant decreases (P < 0.05) after the spinal anesthesia. We concluded that oral premedication of clonidine and tizanidine prolonged tetracaine spinal anesthesia. From the view point of the prolongation of spinal anesthesia and the hemodynamic stability, oral premedication with tizanidine seems to be useful.
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Randomized Controlled Trial Clinical Trial
[Bupivacaine-fentanyl continuous infusion is superior to morphine bolus injection in postoperative epidural analgesia].
We compared bolus injection of morphine 51 +/- 9 micrograms.kg-1 (M-S group) with 48 h-continuous infusion of bupivacaine and fentanyl mixture (BF-C group) for postoperative epidural analgesia in 100 patients who had undergone upper abdominal laparotomy. The epidural analgesia was started about 60 min before completion of surgery. The mixed solution, consisting of bupivacaine 48 ml (240 mg), fentanyl 24 ml (1.2 mg) and 0.9% saline (24 ml), was administered at a rate of 2 ml.h-1 by using a 100 ml balloon infuser. ⋯ There was no significant difference in side effects between the two groups. The plasma fentanyl concentration in the BF-C group (n = 5) was maintained almost constant for the period from 24 to 49 hours after the start of infusion and was approximately 1.6 ng.ml-1. We conclude that continuous infusion of bupivacaine (2.5 mg.ml-1) and fentanyl (12.5 micrograms.ml-1) at a rate of 2 ml.h-1 is superior to bolus injection of morphine for postoperative analgesia.
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Randomized Controlled Trial Clinical Trial
[The effects of low dose clonidine on perioperative hemodynamics and anesthetic requirements in elderly patients].
The effects of clonidine, alpha 2-adrenergic receptor agonist, on perioperative hemodynamics and anesthetic requirements were studied in randomized 20 elderly patients without hypertension (ASA I-II) scheduled for elective abdominal surgery under general anesthesia. The control group (n = 10) was premedicated with oral diazepam 0.1 mg.kg-1 90 min prior to arrival in the operating room. The clonidine group (n = 10), in addition, received clonidine approximately 2.5 micrograms.kg-1 orally at the same time. ⋯ Intraoperative variability of heart rate was significantly lower in patients receiving clonidine compared with controls. No significant differences in the requirements of either isoflurane or narcotic supplementation were observed between the two groups. We conclude that a low dose clonidine is a useful adjunct in the management of elderly patients without producing side effects.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Lack of effect of i.v. lidocaine on cardiovascular responses to laryngoscopy and intubation].
A randomized open study was carried out on 36, ASA I-II adult surgical patients to assess the effect of intravenous lidocaine and fentanyl on circulatory responses to laryngoscopy and intubation. The three treatment groups include: group L, intravenous lidocaine 1.5 mg.kg-1 2 minutes before laryngoscopy, group F, intravenous fentanyl 4 micrograms.kg-1, and group C, no treatment. Induction, preceded by preoxygenation was performed by intravenous vecuronium for precurarisation, followed by thiopental 4-5 micrograms.kg-1 and succinylcholine 1.5 mg.kg-1. ⋯ The maximum values attained after intubation did not differ significantly between the two groups for any of the variables. In group F, these hemodynamic variables showed no significant changes after laryngoscopy and intubation and were significantly less than those in group F and group C. Intubating conditions were better in the fentanyl group than in the lidocaine group.
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Randomized Controlled Trial Clinical Trial
[Influence of epidural anesthesia on the halothane MAC-intubation in emergence in infants and children].
The alveolar anesthetic concentration level at which the patient first shows movement when emerging from anesthesia is defined as MAC-intubation in emergence in infants and children. Twenty one patients of ASA physical status 1, were studied to determine the halothane MAC-intubation in emergence. The patients were divided into two groups; a general anesthesia alone group and a general anesthesia plus epidural anesthesia group. ⋯ The time from the discontinuation of halothane to the first body movement tended to be longer without epidural anesthesia. RR and ETCO2 did not differ between the two groups of patients. The halothane MAC-intubation in emergence in the general anesthesia alone group was 0.26%, and adding epidural anesthesia decreased this concentration to 0.18%.