Articles: anesthesia.
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Anaesth Intensive Care · Nov 1990
Randomized Controlled Trial Comparative Study Clinical TrialThe addition of fentanyl to epidural bupivacaine in first stage labour.
Epidural analgesia was studied in 100 healthy Chinese women with uncomplicated pregnancies in first stage labour. Patients were randomly allocated to receive 8 ml of one of the following five solutions: bupivacaine 0.125% with fentanyl 50 micrograms or fentanyl 100 micrograms, bupivacaine 0.25% plain, bupivacaine 0.25% with fentanyl 50 micrograms or fentanyl 100 micrograms. ⋯ There was no difference in method of delivery or neonatal Apgar scores. The least concentrated mixture providing good quality analgesia for the first stage of labour was the combination of bupivacaine 0.125% with fentanyl 50 micrograms.
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Randomized Controlled Trial Clinical Trial
[Effects of anesthesia on higher brain functions in the elderly].
Sixty-four patients aged over 60 about to undergo elective surgery of the lower limbs were allocated at random to two groups, one with general anaesthesia, the other with local/regional anaesthesia, in order to compare the effects of these two types of anaesthesia on superior brain functions. The two groups were similar in age, disease, treatment and risk from anaesthesia. ⋯ The score decreased to pathological values (less than or equal to 20) in 4 patients from the local/regional anaesthesia group, and this fall was associated with trans- and postoperative incidents (haemorrhage, cardiorespiratory arrest, confusion after receiving pethidine, cardiac decompensation). This study shows that alterations of the superior brain functions are probably related to trans and postoperative incidents rather than to the type of anaesthesia administered.
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Randomized Controlled Trial Clinical Trial
Postoperative analgesic requirements in patients exposed to positive intraoperative suggestions.
To establish whether positive suggestions given to a patient under general anaesthesia reduce postoperative pain and analgesic requirements. ⋯ Positive intraoperative suggestions seem to have a significant effect in reducing patients' morphine requirements in the early postoperative period.
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Anesthesia and analgesia · Oct 1990
Randomized Controlled Trial Comparative Study Clinical TrialCerebrospinal fluid pressure in patients with brain tumors: impact of fentanyl versus alfentanil during nitrous oxide-oxygen anesthesia.
The effects on the cerebrospinal fluid pressure (CSFP) of alfentanil and fentanyl were compared during nitrous oxide-oxygen (N2O-O2) anesthesia in 24 patients who had brain tumors. Monitored variables included CSFP (lumbar subarachnoid catheter), heart rate from electrocardiographic lead II, mean radial arterial blood pressure, and arterial blood gas tensions. General anesthesia was induced with thiopental, 5 mg/kg IV in divided doses, and maintained with 70% N2O in O2; ventilation was held constant (PaCO2 = 37.4 +/- 1.6 mm Hg [mean +/- SEM]). ⋯ Cerebrospinal fluid pressure remained unchanged both in patients who received N2O-O2 alone and in those who received fentanyl-N2O-O2. By contrast, those who received alfentanil-N2O-O2 had a gradual increase in CSFP, reaching 30% above baseline values after 10 min and stabilizing thereafter. Although the absolute increase in CSFP during normocarbic alfentanil-N2O anesthesia was relatively small (9.5 +/- 1.3 mm Hg to 13.0 +/- 1.3 mm Hg [mean +/- SE], P less than 0.05), the absence of a similar effect after fentanyl administration suggests that precautionary measures such as hyperventilation are advisable if alfentanil is used for potentiating normocarbic N2O-O2 anesthesia in neurosurgical patients with intracranial mass lesions.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effects of alfentanil and fentanyl on induction of anaesthesia in patients with severe pregnancy-induced hypertension.
Forty patients with severe pregnancy-induced hypertension presenting for Caesarean section under general anaesthesia were allocated randomly to receive either fentanyl 2.5 micrograms kg-1 or alfentanil 10 micrograms kg-1 as part of the anaesthetic induction sequence. In all patients, the cardiovascular response to tracheal intubation was measured. Both drugs attenuated the response equally but did not abolish it in all patients. Alfentanil 10 micrograms kg-1 is a suitable alternative to fentanyl 2.5 micrograms kg-1 for patients with pregnancy-induced hypertension.