Articles: anesthesia.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Synacthen Depot for the treatment of postdural puncture headache.
We conducted a prospective, randomised, double-blind trial to study the effect of Synacthen Depot in 18 parturients with postdural puncture headache following deliberate or accidental dural puncture. Women were randomly allocated to receive either Synacthen Depot 1 mg (1 ml) or 0.9% saline 1 ml intramuscularly. ⋯ There was no difference in the severity of headache or requirement for epidural blood patch. We conclude that there is no advantage to the use of Synacthen Depot 1 mg for the treatment of postdural puncture headache.
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Anaesth Intensive Care · Feb 2004
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialRandomized evaluation of the single-use SoftSeal and the re-useable LMA Classic laryngeal mask.
A number of laryngeal masks are available, including both re-usable and single-use masks. Single-use laryngeal masks may decrease the risk of transmitting prion infections. We performed a single-blind randomized trial in 200 spontaneously breathing female patients under general anaesthesia with nitrous oxide, to compare a new single-use laryngeal mask, the SoftSeal (Portex Ltd, U. ⋯ An estimation of cost per patient use was greater for the re-usable mask. We conclude that the SoftSeal single-use laryngeal mask and the LMA Classic re-usable laryngeal mask airway are of similar clinical utility in terms of successful insertion and airway maintenance. The re-usable laryngeal mask was easier to insert and associated with less postoperative sore throat, but costs were higher.
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Multicenter Study Clinical Trial
Pharmacokinetics of levobupivacaine 0.25% following caudal administration in children under 2 years of age.
Levobupivacaine, the S(-)enantiomer of racemic bupivacaine is less cardiotoxic than racemic bupivacaine and the R(+)enantiomer dexbupivacaine, while retaining similar local anaesthetic properties and potency to racemic bupivacaine. The pharmacokinetic profiles of the two bupivacaine enantiomers differs and that of racemic bupivacaine may be age dependent. We examined the pharmacokinetics of levobupivacaine after its single shot caudal epidural administration in children. ⋯ After the caudal epidural administration of levobupivacaine 2 mg kg(-1) in children less than 2 yr of age, C(max) was within the accepted safe range for racemic bupivacaine. T(max) varied and occurred later in some children, particularly those aged less than 3 months. Sampling in future pharmacokinetic studies in this age group should extend beyond 60 min.
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Acta Anaesthesiol Scand · Jan 2004
Multicenter Study Clinical TrialAge-related effects in the EEG during propofol anaesthesia.
Age-related differences in the spectral composition of the EEG in induction and emergence times, and in drug consumption during propofol anaesthesia were investigated. ⋯ Older patients differ from younger ones regarding the hypnotic effect of propofol and the spectral patterns in the EEG. For an efficient automatic assessment of the EEG during anaesthesia a multivariable approach accounting for age-effects is indispensable.
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Rev Esp Anestesiol Reanim · Jan 2004
Multicenter Study[Influence of a child's age on anesthetic technique based on analgesia with remifentanil].
To study the possible pharmacodynamic differences in children under anesthesia based on remifentanil. ⋯ No differences were found between age groups with regard to remifentanil requirements, end tidal concentrations of sevoflurane, or mean times until spontaneous ventilation or extubation. Nor were there differences in the percentages of complications (5.4%), of which 4 were cases of intense postoperative muscular rigidity, or in the incidence of nausea-vomiting (3.4%). The quality of recovery from anesthesia (Aldrete test) was better in the 8-12-year-old group (P < 0.05), however, while agitation (Postoperative Agitation Score) and pain (visual analog scale or observational scales) were greater in the group of 1-3-year-olds (P < 0.05). The evaluation of the technique by participating caregivers was excellent for 20%, very good for 41%, good for 29%, adequate for 8% and poor for 2% of the cases.