Articles: anesthesia.
-
Paediatric anaesthesia · Jan 2002
Randomized Controlled Trial Multicenter Study Clinical TrialThe efficacy of caudal ropivacaine 1, 2 and 3 mg x l(-1) for postoperative analgesia in children.
The aim of this double blind, randomized, comparative study was to assess the analgesic efficacy and incidence of motor block after caudal block using three different concentrations of ropivacaine, 1, 2 and 3 mg x l(-1), in children 4-12-year-old. ⋯ It was concluded that 1 ml x kg(-1) of ropivacaine 2 mg x ml(-1) for caudal block provided satisfactory postoperative pain relief after inguinal surgery in 4-12-year-old children. Ropivacaine 1 mg x ml(-1) showed less efficacy while the use of ropivacaine 3 mg x ml(-1) was associated with a higher incidence of motor block with minimal improvement in postoperative pain relief.
-
Multicenter Study
The use of local anaesthesia in peripheral venous cannulation: current practice of junior doctors.
To determine the rate of use of local anaesthetic in peripheral venous cannulation by pre-registration house officers and to determine reasons why they do not use it. ⋯ Despite good clinical evidence that the pain of peripheral venous cannulation can be successfully obviated using local anaesthetic, the rate of use by pre-registration house officers is low. It is suggested that during formal cannulation training, more emphasis be placed on the provision of analgesia. This should aim to increase the quality of care to those patients requiring intravenous cannulation as well as offering other potential benefits to doctors.
-
Randomized Controlled Trial Multicenter Study Clinical Trial
Fresh gas flow is not the only determinant of volatile agent consumption: a multi-centre study of low-flow anaesthesia.
Seven academic centres studied 302 patients, using desflurane, enflurane, halothane, or isoflurane using circle-systems and Dräger Julian anaesthetic machines, with fresh gas flows (V(F)) of 3, 1, and 0.5 litre min(-1). Volatile agent partial pressures in the breathing system were recorded and agent consumptions measured by weighing. ⋯ At V(F) that involves significant re-breathing, consumption of soluble agents depends only partially on V(F). These results can be explained using Mapleson's hydraulic analogue model.
-
Acta Anaesthesiol Belg · Jan 2002
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialRemifentanil vs. alfentanil for direct laryngoscopy: a randomized study comparing two total intravenous anaesthesia techniques. TIVA for direct laryngoscopy.
The ideal anaesthesia for direct laryngoscopy is profound and yet brief. The present study sought to determine whether a new anaesthetic technique based on infusion of the ultra short-acting opioid remifentanil was superior to our routine alfentanil multiple-dose technique in terms of haemodynamic stability, stress responses and recovery. A total of 58 patients were randomized to receive propofol and either remifentanil or alfentanil as part of a total intravenous anaesthesia. ⋯ In the remifentanil group, hypotension or bradycardia requiring intervention arose in 5 (18%) and 3 patients (11%); neither response was seen in the alfentanil group. The period from the end of propofol infusion until extubation was 5 min longer in the remifentanil group (P < 0.0001), whereas the time from extubation until discharge was similar in the two groups. Thus, neither technique showed sufficient haemodynamic stability, and further studies are needed to determine optimal dosages of propofol and opioid.
-
Paediatric anaesthesia · Jan 2002
Multicenter StudyA survey of practice of tracheal intubation without muscle relaxant in paediatric patients.
Because of the renewed interest in intubation in children without relaxants, over a period of 1 month, the anaesthesiologists of five paediatric universitary teaching hospitals were asked to complete a questionnaire each time they performed a tracheal intubation without muscle relaxant. ⋯ Sevoflurane is the most commonly used agent for tracheal intubation without relaxants with higher doses being required in infants aged less than 6 months. Propofol, even with opioids, was not so successful.