European journal of anaesthesiology. Supplement
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Eur J Anaesthesiol Suppl · Jan 2003
Randomized Controlled Trial Meta Analysis Clinical TrialMeta-analysis of single dose oral tramadol plus acetaminophen in acute postoperative pain.
Trials in acute postoperative pain are usually small. Pooling homogenous data from a number of trials in a meta-analysis enables a truer estimate of efficacy. The aims of the present meta-analysis were to assess the analgesic efficacy and adverse effects of single-dose oral tramadol plus acetaminophen (paracetamol) in acute postoperative pain, and to demonstrate the efficacy of the combination formulation compared with its components. ⋯ Meta-analysis confirmed the analgesic superiority of the combination treatment over its components, without additional toxicity. Combination analgesic formulations are an important and effective means of pain relief, and should prove useful in treating elderly and other groups of patients who often cannot tolerate non-steroidal anti-inflammatory drugs, including the newer COX-2 inhibitors.
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Eur J Anaesthesiol Suppl · Nov 1995
Randomized Controlled Trial Comparative Study Clinical TrialPropofol versus propofol with midazolam for laryngeal mask insertion.
We evaluated the addition of midazolam to propofol during induction of anaesthesia by assessing laryngeal mask tolerance, haemodynamic variables, recovery times and cost. Forty patients (ASA grades I-IV) undergoing elective surgery were allocated randomly to receive a standard dose of propofol or a smaller dose of propofol combined with midazolam. A laryngeal mask was inserted and any episodes of coughing or hiccuping during its insertion or removal were recorded. ⋯ No significant differences were detected in any variables, except that patients given propofol needed more morphine in the recovery ward. The average cost of propofol alone was 3.47 pounds per anaesthetic, while the midazolam plus propofol cost was 2.03 pounds. Adding midazolam to propofol allowed a reduced dose of propofol to be used without adverse effects, while reducing the anaesthetic costs.
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Eur J Anaesthesiol Suppl · Sep 1995
Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical TrialTime-course of action and intubating conditions with rocuronium bromide under propofol-alfentanil anaesthesia.
Thirty ASA I and II patients received either an intubating dose of 0.6 mg kg-1 rocuronium (2 x ED95, group 1) or 0.06 mg kg-1 as a priming dose followed by an intubating dose of 0.24 mg kg-1 rocuronium (group 2) 4 min later. Anaesthesia was induced with propofol (2.0 mg kg-1) and alfentanil (0.02 mg kg-1) and maintained with nitrous oxide/oxygen and propofol (6.0 mg kg-1 h-1). Neuromuscular function was monitored mechanomyographically and electromyographically with train-of-four (TOF) stimulation at the wrist every 10 s. ⋯ Mechanomyography showed a significantly faster development of neuromuscular block than electromyography. The comparison of mechanomyographically and electromyographically measured recovery times did not show any differences. In 60% of the patients a priming dose of 0.06 mg kg-1 was followed by a considerable decrease in neuromuscular function.
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Eur J Anaesthesiol Suppl · Sep 1995
Randomized Controlled Trial Comparative Study Clinical TrialRocuronium- and mivacurium-induced neuromuscular block and intubating conditions: a comparison with vecuronium.
The time-course of action after an initial 2 x ED90 dose and after maintenance doses of 0.5 x ED90, and intubating conditions at 90 s after a 2 x ED90 dose following rocuronium, vecuronium and mivacurium were evaluated in anaesthetized adult patients. Neuromuscular measurements were performed with mechanomyography. ⋯ At 90 s, intubating conditions were significantly better in the rocuronium group than in the vecuronium or mivacurium group. Mivacurium offered a significantly faster recovery of neuromuscular block following the 2 x ED90 dose and following an average of 45 min of clinical muscle relaxation (single twitch response < or = 25%) compared to rocuronium and vecuronium: clinical duration 13 (4), 28 (9) and 33 (9) min, respectively, and recovery time from 25 to 75% recovery of the single twitch response: 6 (2), 11 (4) and 14 (7) min, respectively.
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Eur J Anaesthesiol Suppl · Sep 1995
Randomized Controlled Trial Comparative Study Clinical TrialDose-response and time-course of action of rocuronium bromide.
Rocuronium is a new aminosteroidal muscle relaxant, the main feature of which is a low potency compared to other aminosteroidal muscle relaxants. The ED95 is approximately 0.3 mg kg-1, although the estimated potency may vary slightly with different modes of stimulation and under different anaesthetic techniques. ⋯ The estimated potency is similar in adults and the elderly, although the ED95 may be slightly higher in children. Rocuronium is affected in the same way as vecuronium by the use of volatile anaesthetic agents.