Articles: reflex-drug-effects.
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Randomized Controlled Trial
Remifentanil and etomidate for laryngeal mask airway insertion.
Etomidate does not depress the upper airway reflexes, making it difficult to insert a laryngeal mask airway (LMA) when using it for anaesthesia. This study investigated the effect of adding remifentanil to etomidate for LMA insertion. Fifty adult patients, undergoing cystoscopy, were randomized to two groups. ⋯ Only 13 LMAs were inserted at the first attempt in the etomidate-remifentanil group compared with 23 in the propofol-remifentanil group. Gagging, chest rigidity and myoclonus occurred significantly more frequently in the etomidate-remifentanil group. We conclude that the addition of remifentanil to etomidate anaesthesia induction does not improve LMA insertion.
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Randomized Controlled Trial Comparative Study
Comparison of desflurane with sevoflurane for the incidence of oculocardiac reflex in children undergoing strabismus surgery.
The oculocardiac reflex (OCR) is frequently observed during strabismus surgery. This study was designed to evaluate and compare the effect of sevoflurane and desflurane on the incidence of OCR. ⋯ Both agents can be used safely during strabismus surgery in paediatric patients.
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Acta Anaesthesiol Scand · Jul 2007
Randomized Controlled TrialSingle bolus of intravenous ketamine for anesthetic induction decreases oculocardiac reflex in children undergoing strabismus surgery.
Oculocardiac reflex (OCR) is a major complication of pediatric strabismus surgery. The aim of the present study was to determine whether a single bolus of intravenous (i.v.) ketamine for anesthetic induction can decrease OCR in children undergoing strabismus surgery. ⋯ A single bolus of i.v. ketamine 1 or 2 mg/kg for anesthetic induction results in a lower incidence of OCR than propofol when combined with sevoflurane for maintenance in children undergoing strabismus surgery.
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Biological psychology · Apr 2007
Randomized Controlled TrialNociceptive flexion reflex and pain rating responses during endogenous opiate blockade with naltrexone in healthy young adults.
The effect of opioid blockade on nociceptive flexion reflex (NFR) activity and subjective pain ratings was examined in 151 healthy young men and women. Using a within-subjects design, NFR threshold was assessed on 2 days after administration of either placebo or a 50mg dose of naltrexone. Electrocutaneous pain threshold and tolerance levels were measured after NFR threshold assessment on each day. ⋯ Specifically, participants exhibited lower levels of NFR activity and reported lower pain ratings for electrocutaneous stimulation delivered at pain threshold and tolerance levels following administration of naltrexone as compared to placebo. These findings indicate that opiate blockade using the current standard dose may elicit hypoalgesia. A potential moderating effect of dose of opiate-blockade medication and level of endogenous opioid activation should be carefully examined in future research.
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Acta Anaesthesiol Scand · Mar 2007
Randomized Controlled TrialLidocaine exerts its effect on induced bronchospasm by mitigating reflexes, rather than by attenuation of smooth muscle contraction.
Lidocaine inhalation attenuates histamine-induced bronchoconstriction, as well as bronchoconstriction elicited by mechanical irritation. This effect could be mediated by direct effects on smooth muscle or by reflex attenuation. Therefore, we evaluated whether lidocaine attenuated the bronchial response of direct smooth muscle stimulation with methacholine. ⋯ Although both inhaled and intravenous lidocaine attenuates histamine-evoked bronchoconstriction, it does not alter the response to methacholine. Therefore, the attenuation of bronchial reactivity by lidocaine appears to be related solely to neurally mediated reflex attenuation, rather than to the attenuation of direct constriction of airway smooth muscle.