Articles: general-anesthesia.
-
Randomized Controlled Trial Comparative Study Clinical Trial
[The significance of tramadol as an intraoperative analgesic. A randomized double-blind study in comparison with placebo].
Tramadol-N2O anaesthesia as recommended by Stoffregen was studied in 40 patients (ASA I-II) undergoing elective orthopaedic or lower abdominal surgery. Fentanyl and droperidol (Thalamonal)/atropine were given as i.m. premedication, induction was performed using methohexitone, succinylcholine and pancuronium, ventilation was controlled by means of a Takaoka respirator (N2O/O2 79:21, 4 breaths/min). Intraoperative analgesia was provided by a biphasic tramadol infusion. ⋯ When enflurane had not been necessary (tramadol n = 13, placebo n = 10), mean percentage rises of blood pressure or pulse rate, related to preoperative values, were found to be slightly higher in the tramadol group. Postoperative analgesic requirement was reduced significantly after tramadol. Striking differences between the two groups, on the other hand, were shown with respect to intraoperative awareness: while patients receiving placebo proved to be amnaesic, 65% of tramadol patients were aware of intraoperative music.(ABSTRACT TRUNCATED AT 250 WORDS)
-
Ann Fr Anesth Reanim · Jan 1985
Randomized Controlled Trial Clinical Trial[Determination of the dose-response curve for atracurium dibesylate in the anesthetized adult].
The mechanical response of the adductor pollicis to a 0.15 Hz stimulation of the ulnar nerve was studied in 35 unpremedicated adult patients (mean age 38 yr) under general anaesthesia using thiopentone, fentanyl and a N2O/O2 mixture under mechanical ventilation. PaCO2, pH, K, Ca, Mg plasma levels and temperature were in the normal range. Each patient received a single bolus of atracurium dibesylate: 0.10 mg . kg-1 (n = 11), 0.15 mg . kg-1 (n = 10), 0.20 mg . kg-1 (n = 11) or 0.30 mg . kg-1 (n = 4). ⋯ The 0.3 mg . kg-1 dose resulted in onset time of 4.7 +/- 1.3 min, duration of 39.9 +/- 3.7 min and a recovery index of 10.7 +/- 1.8 min. Thus atracurium dibesylate seemed to be an agent of intermediate potency. Onset time was approximately the same as that for other non-depolarizing neuromuscular blocking drugs, but duration of action and recovery index were quite shorter, except for vecuronium bromide.
-
As diagnostic methods of detecting drug-specific IgE antibodies become more sophisticated, the evidence implicating specific IgE in anaesthetic allergy has increased. To implicate IgE in reactions, a history resembling anaphylaxis, the demonstration of drug-specific histamine release by intradermal testing and the demonstration of specific antibodies are necessary. Such evidence is seen in 70% of muscle relaxant reactors. Basophil histamine release studies suggest that histamine release is allergen-induced, not direct, and the final evidence necessary is to demonstrate the role of drug-specific antibodies in such histamine release.