Articles: general-anesthesia.
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Anestezjol Intens Ter · Jan 2008
Review[New opioids for general anaesthesia and in- and out-hospital analgesia].
Over the last 30 years, three new opioids of the piperidine family have been introduced to anaesthesia clinical practice: sufentanil, alfentanil and remifentanil. Alfentanil is a derivative of fentanyl, with quicker onset than that of fentanyl and with shorter duration and more intense vagomimetic properties than those of fentanyl and sufentanil. It may cause less intense respiratory depression than equianalgesic doses of fentanyl. ⋯ It is a potent analgesic, recommended for strong postoperative pain. Butorphanol is a potent analgesic that increases heart rate, arterial and pulmonary blood pressures and cardiac output. It should be given carefully in patients with coronary disease.
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Cochrane Db Syst Rev · Jan 2008
Review Meta AnalysisTarget-controlled infusion versus manually-controlled infusion of propofol for general anaesthesia or sedation in adults.
Continuous infusions of the intravenous anaesthetic propofol are commonly used to induce and maintain sedation and general anaesthesia. Infusion devices can be manually controlled (MCI) where the anaesthetist makes each change to the infusion rate or target-controlled (TCI) where the anaesthetist sets a target blood or effect-site concentration and the computerised infusion device makes the necessary changes to the infusion rate. Randomized trials have explored the differences in quality of anaesthesia, adverse event rate and cost between TCI and MCI but the effectiveness of TCI compared with MCI remains controversial. As TCI is in widespread international use, and potentially may be more expensive without added benefit, a systematic review of randomized controlled trials comparing TCI and MCI is warranted. ⋯ This systematic review does not provide sufficient evidence for us to make firm recommendations about the use of TCI versus MCI in clinical anaesthetic practice.