Articles: general-anesthesia.
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Acta Anaesthesiol Belg · Jun 1985
Randomized Controlled Trial Comparative Study Clinical TrialHormonal response in thoracic surgery. Effects of high-dose fentanyl anesthesia, compared to halothane anesthesia.
Thirty two patients undergoing cardiac thoracic surgery were randomly assigned into two groups: Patients of the first group received high dose fentanyl (50 micrograms/kg) at the induction and patients of the second group received halothane for the maintenance of anesthesia. All patients received N2O:O2 and pancuronium for muscle relaxation. Surgical stress, as evaluated by changes in blood pressure, heart rate, plasma cortisol and glucose levels, appeared in the halothane group but not in the fentanyl group. ⋯ Nevertheless two of these patients presented hypoventilation requiring intubation and naloxone administration. High dose fentanyl anesthesia may prove to be very useful in non cardiac thoracic surgery as it protects the patient from the stress of the operation and assures prolonged postoperative analgesia. When this technique is used one must always anticipate postoperative mechanical ventilation.
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Randomized Controlled Trial Clinical Trial
Maternal and neonatal responses related to the volatile agent used to maintain anaesthesia at caesarean section.
A standardized technique of general anaesthesia, with one randomly selected variable, was provided for 237 patients undergoing elective and 540 undergoing emergency Caesarean section. The variable was the volatile agent used to maintain anaesthesia, the choice resting between trichloroethylene (0.2 or 0.3 vol.%) and halothane (0.2, 0.3, 0.4 or 0.5 vol.%). No association was found between the type of agent and the duration of anaesthesia, or the duration of either the I-D or the U-D interval. ⋯ The incidence of maternal awareness plus unpleasant dreams was unacceptably high when the lower concentrations were used, and it is recommended that either trichloroethylene 0.3 vol.% or halothane 0.4 or 0.5 vol.% be used. Neither agent, at these concentrations, was associated with neonatal depression in group A elective sections in which the fetus presented by the vertex, and although there was a possible tendency for their use in cases of fetal compromise to be associated with an increase in the incidence of neonatal respiratory depression, the degree of depression was of little consequence to neonatal well-being. It was confirmed that breech presentation and prolongation of the U-D interval are important determinants of depression and birth asphyxia among infants delivered by Caesarean section under general anaesthesia.
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Anasth Intensivther Notfallmed · Apr 1985
Randomized Controlled Trial Comparative Study Clinical Trial[Circulatory effects of vecuronium as well as pancuronium under different conditions of anesthesia].
The cardiovascular effects of equipotent doses (1,25 X ED95) of vecuronium (70 micrograms/kg iv) and pancuronium (80 micrograms/kg iv) were studied in 16 patients scheduled for elective coronary artery bypass surgery during steady-state conditions of isoflurane (0,4-0,5 vol% end-tidal)-nitrous oxide anaesthesia. All patients were chronically treated with oral beta receptor-blocking agents. Vecuronium did not cause any significant cardiovascular changes whereas pancuronium produced increases in heart rate (13%), cardiac index (15%) and mean arterial pressure (4%) while systemic vascular resistance decreased (8%). ⋯ The administration of pancuronium (80 micrograms/kg) caused the greatest percentage increases in HR (20%), CI (22%), MAP (8%) and RPP (31%) in this group of patients. In contrast, patients (n = 8) anaesthetized with isoflurane-nitrous oxide who were not on preoperative beta-receptor blocker medication, demonstrated higher haemodynamic control values and less increases in HR (10%), CI (10%) and RPP (15%), MAP did not change. The clinical significance of these findings is discussed.
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Br J Clin Pharmacol · Mar 1985
Randomized Controlled Trial Clinical TrialThe evaluation of domperidone and metoclopramide as antiemetics in day care abortion patients.
A randomised double-blind investigation was undertaken to assess the value of domperidone and metoclopramide as prophylactic anti-emetics in unpremedicated patients undergoing general anaesthesia for therapeutic abortion on a day care basis. Sixty patients were divided into three groups, and received, at induction, one of three drugs intravenously. The incidences of postoperative nausea and vomiting were 35% in the group receiving normal saline as placebo, 30% in the group receiving 10 mg domperidone and 25% in the group receiving 10 mg metoclopramide; these were not statistically significantly different. Furthermore, there was no statistically significant difference in the incidence of postoperative nausea and vomiting as influenced by age, weight, length of gestation, anaesthetic time and a history of nausea and vomiting during the pregnancy.
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Anaesth Intensive Care · Feb 1985
Randomized Controlled Trial Comparative Study Clinical TrialClinical comparison of atracurium and alcuronium in gynaecological surgery.
In a double-blind, prospective, randomised trial in 51 female patients, atracurium 0.6mg/kg provided acceptable intubating conditions more rapidly than did alcuronium 0.25 mg/kg. Atracurium produced more profound neuromuscular twitch suppression than alcuronium. ⋯ Two cases of sinus bradycardia were noted in the atracurium group, but hypotension was not a clinical problem in any patient. Atracurium appears to be a useful relaxant, but a smaller dose than that used here should be chosen for short procedures.