Articles: general-anesthesia.
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Randomized Controlled Trial Clinical Trial
Early extubation after high-dose fentanyl anaesthesia for aortocoronary bypass surgery: reversal of respiratory depression with low-dose nalbuphine.
To investigate the possibility of selective reversal of narcotic-induced respiratory depression following fentanyl anaesthesia, we studied 20 patients after aortocoronary bypass surgery. All patients were anaesthetized with fentanyl, 40 micrograms . kg-1 and oxygen, with isoflurane as indicated. In a random double blind fashion either incremental doses of nalbuphine, or normal saline were administered approximately four hours after cardiopulmonary bypass. ⋯ We conclude that low-dose nalbuphine is not an acceptable method of antagonism of respiratory depression in this group of patients. Many patients who did not receive nalbuphine were able to breathe adequately at an earlier stage than was previously suspected. Close monitoring of the respiratory system may permit earlier extubation without the requirement of a narcotic antagonist after this dose of fentanyl.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cardiovascular responses to the insertion of nasogastric tubes during general anaesthesia.
Eighty female patients free of cardiovascular disease who were having excision of breast lesions were randomly allocated to one of two groups. In the first group a nasogastric tube was inserted blindly during the surgical procedure, while in the second group the tube was inserted under direct laryngoscopy, using Magill forceps. ⋯ These increases declined during the following 3 minutes. Ventricular extrasystoles (more than 5 during the 3 min following the insertion of the nasogastric tube) occurred only in the group having the nasogastric tube with the aid of laryngoscopy (p less than 0.05).
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Anesthesia and analgesia · Sep 1985
Randomized Controlled Trial Comparative Study Clinical TrialEtomidate versus thiopental for induction of anesthesia.
Hemodynamic changes and side effects of anesthesia induction with etomidate or thiopental were evaluated in 83 ASA class I or II patients. Patients were randomly assigned to one of 12 groups according to pretreatment drug (fentanyl, 100 micrograms, or normal saline intravenously), induction agent (etomidate, 0.4 mg/kg, or thiopental, 4 mg/kg), and maintenance anesthetic technique (isoflurane-oxygen, isoflurane-nitrous oxide-oxygen, or fentanyl-nitrous oxide-oxygen). The purpose of this experiment, of factorial design, was to evaluate the combined effects of two or more experimental variables used simultaneously and to observe interaction effects. ⋯ Patients in whom anesthesia was induced with etomidate had a greater incidence of pain on injection and myoclonus and a lesser incidence of apnea than patients in whom anesthesia was induced with thiopental. Fentanyl pretreatment significantly decreased the incidence of pain on injection and myoclonus, but it increased the incidence of apnea when anesthesia was induced with etomidate. The incidence of postoperative nausea and vomiting was similar after thiopental and etomidate and was unaffected by fentanyl pretreatment. (ABSTRACT TRUNCATED AT 250 WORDS)
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Southern medical journal · Jul 1985
Randomized Controlled Trial Comparative Study Clinical TrialEvaluation of ranitidine as an oral antacid in outpatient anesthesia.
We studied the effects of preanesthetic ranitidine on gastric contents in 60 outpatients scheduled for elective surgery, with random allocation into three groups of 20 patients each. Patients in group 1 did not receive ranitidine and served as controls. Patients in groups 2 and 3 received ranitidine orally, 150 and 300 mg, respectively, one to five hours before induction of anesthesia. ⋯ Mean gastric volume and proportion of patients with volume greater than or equal to 20 ml were significantly reduced in both treatment groups. Proportions of patients with combination of pH less than or equal to 2.5 and volume greater than or equal to 20 ml were significantly low in both treatment groups, as there was only one patient in group 2 and none in group 3 with both low pH and high volume. With respect to reduction of gastric acidity and volume, 300 mg of ranitidine had no advantage over 150 mg.
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Randomized Controlled Trial Clinical Trial
Mental function and morbidity after acute hip surgery during spinal and general anaesthesia.
Forty elderly patients (mean age 78.9 years) undergoing acute surgery for hip fracture were given at random either spinal analgesia with bupivacaine 0.75% or general anaesthesia with diazepam, fentanly and N2O/O2. Mental function was studied pre-operatively with an abbreviated mental test and 1 week and 3 months postoperatively in both groups. Mortality and number of complications was similar in the two groups, but a shorter time of ambulation was seen in the spinal group compared to the general anaesthetic group. No persistent impairment in mental function was found after acute hip surgery under spinal or general anaesthesia and the only advantage of regional technique was a shorter time of ambulation.