Articles: general-anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
Use of EEG spectral edge as index of equipotency in a comparison of propofol and isoflurane for maintenance of general anaesthesia.
Propofol and isoflurane were compared for haemodynamic stability and recovery time as main anaesthetic agents for maintenance in a total of 43 ASA I and II patients in uncomplicated operations lasting at least 30 min. The premedication (oral diazepam), induction (thiopentone-fentanyl-suxamethonium) and maintenance protocol (N2O-O2 2:1 litre min-1, fentanyl and vecuronium in incremental doses) were identical for all patients. In one group of 20 patients, propofol was used in continuous intravenous (i.v.) infusion (starting dose 3 mg kg-1 h-1), while in the second group of 23 patients, isoflurane was administered in a starting concentration of 1%. ⋯ The incidence of mean blood pressure deviations/case in the propofol group was less than half of those occurring in the isoflurane group (0.45 vs. 0.96 P = 0.04). The mean duration of blood pressure deviation from baseline value was 5.5 min in the propofol group vs. 16.8 min in the isoflurane group (P = 0.01). The recovery intervals were significantly shorter in the propofol group (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
The effect of clonidine on intra-operative requirements of fentanyl during combined epidural/general anaesthesia.
The study evaluates the analgesic effects of epidural clonidine in patients undergoing abdominal hysterectomy under combined epidural/general anaesthesia. Forty ASA 1-2 patients were divided into two groups who received epidurally either clonidine 300 micrograms (group 1) or placebo (group 2). Anaesthesia was maintained with oxygen/nitrous oxide, a midazolam infusion, vecuronium, and boluses of fentanyl 100 micrograms administered as needed to maintain cardiovascular stability. ⋯ Patients in Group 1 had a lower heart rate after tracheal intubation and surgical incision (p < 0.02). In the recovery room, pain intensity was lower in group 1 (p < 0.003) and the mean (SD) time until analgesia request was increased from 48.5 (8.4) min in group 2 to 235.7 (33.2) min in group 1 (p < 0.001). Our results demonstrate that epidural clonidine produces decreased fentanyl requirements, improved cardiovascular stability, reduced pain intensity and effective postoperative analgesia in the recovery room.
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Review Randomized Controlled Trial Clinical Trial
[Medical therapy for coronary heart disease. Perioperative relevance].
The aim of our review is to summarize relevant data on the perioperative use of anti-ischaemic drugs in patients at risk for or with proven coronary heart disease. ⋯ Beta-blockers, calcium channel blockers, nitrates, and possibly alpha 2-agonists lead to reduced rates of PMI and other cardiac complications in risk patients. Current anti-anginal medications, with the exception of anti-platelet agents, should be maintained to the day of surgery and continued as soon as possible thereafter. All of these drugs except anti-platelet agents may also be used intra-operatively, however, possible interactions with anaesthetic agents should be carefully considered.
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Randomized Controlled Trial Clinical Trial
Assessment of intubating conditions in children after induction with propofol and varying doses of alfentanil.
We have assessed tracheal intubating conditions in 60 ASA I or II children, aged 3-12 yr, after induction of anaesthesia with alfentanil 5, 10 or 15 micrograms kg-1, followed by an induction dose of propofol. Neuromuscular blocking agents were not given. ⋯ Intubation was successful in 70%, 95% and 95% of patients after alfentanil 5, 10 or 15 micrograms kg-1, respectively, and conditions were considered to be excellent in 20%, 70% and 80% of patients, respectively. Side effects included pain on injection of propofol (27%), excitatory movements (5%) and bradycardia (1.7%).
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Anesthesia and analgesia · Nov 1994
Randomized Controlled Trial Comparative Study Clinical TrialCost comparison: a desflurane- versus a propofol-based general anesthetic technique.
The purpose of this study was to compare the cost of a desflurane-based with a propofol-based general anesthetic technique. Fifty ambulatory orthopedic surgery patients were randomly assigned to one of two groups. Premedication and induction of anesthesia were standardized in both groups. ⋯ In conclusion, maintenance general anesthesia with our desflurane technique was considerably less expensive than with our propofol technique. PACU stay was not increased using desflurane as opposed to propofol in our study. Desflurane offers a cost effective alternative to propofol for ambulatory general anesthesia.