Articles: general-anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of desflurane and isoflurane in anaesthesia for dental surgery.
We studied 50 ASA I-II patients, aged 18-65 yr, undergoing elective orofacial surgery. Anaesthesia was induced with fentanyl and propofol, and maintained with 66% nitrous oxide in oxygen and either desflurane or isoflurane to compare recovery characteristics and cardiovascular stability. Cardiovascular responses to induction, intubation and incision were similar with both agents, although the increase in heart rate in response to intubation was less marked in the desflurane group. ⋯ Mean duration of anaesthesia was 46 (SD 17.9) min (range 25-89 min) in the desflurane group and 41 (11.5) (23-60) min in the isoflurane group. Times to extubation were 6.7 (2.1) (3-10) min and 11.3 (4.1) (5-23) min, to eye opening 6.8 (2.2) (3-11) min and 12.7 (6.9) (7-37) min, to stating date of birth 9.0 (2.3) (4-12) min and 15.0 (6.9) (8-39) and to discharge from the recovery room 45 (11.6) (22-80) min and 64 (20.9) (28-134) min, for the desflurane and isoflurane groups, respectively (all P < 0.0001). No serious complications occurred in any patient.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of maintenance and recovery characteristics of sevoflurane-nitrous oxide and enflurane-nitrous oxide anaesthesia.
We compared maintenance of anaesthesia and recovery using either sevoflurane or enflurane anaesthesia in ASA I-III patients undergoing surgery with an anticipated minimum duration of 3 h. Serum fluoride concentrations were also measured to assess the potential for renal toxicity. After induction of anaesthesia with thiopentone, patients received, for maintenance, either 1.5% end-tidal sevoflurane (0.73 MAC) with N2O 58% (0.58 MAC) (n = 40) or 1.2% end-tidal enflurane (0.7 MAC) with N2O 57% (0.57 MAC) (n = 40). ⋯ The mean peak plasma inorganic fluoride ion concentrations were reached 4 h after operation in both groups (27.7 microM L-1 for sevoflurane and 16.75 microM L-1 for enflurane, P < 0.05) declining 50% within 24 h in both groups. A positive correlation (P < 0.05) was found between anaesthetic exposure (MAC h) and fluoride concentrations in the two groups. Sevoflurane anaesthesia resulted in similar haemodynamic stability, recovery times and post-operative side effects as enflurane anaesthesia, but produced significantly greater serum fluoride levels.
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Randomized Controlled Trial Comparative Study Clinical Trial
Recovery after electroconvulsive therapy: comparison of propofol with methohexitone anaesthesia.
We have studied prospectively 39 patients receiving a course of electroconvulsive therapy (ECT) for major depressive disorder; they were allocated randomly to receive either propofol or methohexitone for anaesthesia. Recovery after the third ECT treatment was assessed by finger tap and digit symbol substitution tests at 15, 30, 45, 60 and 90 min after induction. ⋯ There was no significant difference in psychometric recovery for drug type, duration of the seizure or initial severity of depression. These results suggest that the more rapid recovery rates noted with propofol in other procedures are not evident after electrically induced seizures.
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Randomized Controlled Trial Clinical Trial
Effect of intrathecal sufentanil on isoflurane requirements during lower abdominal surgery.
To determine the effect of intrathecal sufentanil on volatile anesthetic requirements during lower abdominal surgery. ⋯ Prior administration of intrathecal sufentanil significantly decreases the isoflurane requirement in surgical patients, in addition to its previously demonstrated rapid onset and receptor efficacy.