Articles: anesthesia.
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Multicenter Study Clinical Trial
The safety and efficacy of cisatracurium 0.15 mg.kg(-1) during nitrous oxide-opioid anaesthesia in infants and children.
We studied the neuromuscular and cardiovascular effects of a single, rapidly administered intravenous dose of cisatracurium 0.15 mg.kg(-1) in 27 infants (aged 1-23 months) and 24 children (aged 2-12.5 years). After midazolam premedication, anaesthesia was induced and maintained with thiopental and alfentanil in addition to nitrous oxide in oxygen. Neuromuscular function was monitored by evoked adductor pollicis electromyography. ⋯ Once neuromuscular function started to recover, the rate of recovery was similar in both age groups. Changes in blood pressure and heart rate after the administration of cisatracurium were negligible in both age groups. Cisatracurium, at a dose of 0.15 mg. kg(-1), was effective and well tolerated in infants and children.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A multicenter randomized double-blind comparison of remifentanil and alfentanil during total intravenous anaesthesia for out-patient laparoscopic gynaecological procedures.
We compared Remifentanil, an esterase-metabolized opioid, with Alfentanil as part of the total intravenous anesthesia with propofol and atracurium for out-patient laparoscopic gynaecological procedures in a multicenter randomized, double-blind study. We chose Remifentanil 1 mg./kg.for bolus injection and a continuous infusion of 0.25-0.5 microg./kg./min, compared to Alfentanil 20 microg./kg. For bolus injection and a continuous infusion of 0.5-1 microg./kg./min. ⋯ The incidence of intraoperative bradycardia was significantly higher with Remifentanil. Other incidences of nausea, emesis, urinary retention and postural hypotension were similar. All patients were ready to be discharged from the hospital within two hours after extubation except for one patient in the Alfentanil group who needed five hours of hospital stay because of urinary retention, nausea and severe emesis.
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Multicenter Study Comparative Study
Injectable versus topical anesthesia for cataract surgery: patient perceptions of pain and side effects. The Study of Medical Testing for Cataract Surgery study team.
To compare patient reports of intraoperative pain and postoperative side effects by different anesthesia strategies for cataract surgery. ⋯ Patient reports of any pain during cataract surgery (5%) and postoperative side effects (16% drowsiness and 4% nausea and vomiting) were low, but varied by anesthesia strategy. Patient perceptions of pain and side effects can be helpful in guiding the appropriate choice of anesthesia strategy.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2000
Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial[Endocrine stress parameters during TIVA with remifentanil or sufentanil].
Increases of heart rate and blood pressure during anaesthesia are interpreted as a response to surgical stimulation, although the endocrine response and the cardiovascular reaction can differ markedly. We compared remifentanil and sufentanil as part of a TIVA for retinal surgery with respect to the endocrine stress responses and haemodynamic reactions. ⋯ The increase of prolactin concentrations could be interpreted as a result of the stimulation of mu 1-receptors. As all other measured stress hormones did not increase in both groups, remifentanil and sufentanil both provide an effective suppression of noxious stimulation induced endocrine response.
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Multicenter Study Clinical Trial
Ropivacaine pharmacokinetics after caudal block in 1-8 year old children.
We studied the pharmacokinetics after caudal block of ropivacaine (2 mg ml-1, 1 ml kg-1) performed in 20 children aged 1-8 yr undergoing subumbilical surgery, in this open, non-comparative, multicentre study. Venous blood samples were collected up to 12-36 h. The mean (SD) peak plasma concentration, 0.47 (0.16) mg litre-1, was achieved after 12-249 min. ⋯ Clearance was 7.4 (1.9) ml min-1 kg-1 and the terminal half-life 3.2 (0.8) h. Thus, the free plasma concentrations of ropivacaine were well below those associated with toxic symptoms in adults and the capacity to eliminate ropivacaine seems to be well developed in this age group. In this open study of 20 patients, ropivacaine was well tolerated and provided satisfactory postoperative pain relief without observable motor block.