Articles: anesthesia.
-
Regional anesthesia · Jul 1990
Randomized Controlled Trial Comparative Study Clinical TrialComparison of 0.75% ropivacaine with epinephrine and 0.75% bupivacaine with epinephrine in lumbar epidural anesthesia.
Forty-three ASA physical status I and II patients, scheduled for elective urologic surgery, were randomly entered into a randomized double-blind study using 20 ml bupivacaine 0.75% or 20 ml ropivacaine 0.75%, both with 5 micrograms/ml epinephrine. Two patients were excluded from evaluation of efficacy due to technical failure. After a test dose of 3 ml bupivacaine 0.75% with epinephrine or ropivacaine 0.75% with epinephrine, 17 ml of either solution was given in incremental doses over 4 minutes (4, 4, 4, and 5 ml). ⋯ No postoperative adverse events related to anesthesia were observed. Ropivacaine 0.75% with epinephrine is an effective long-acting local anesthetic. Duration of sensory block is similar to that of bupivacaine 0.75% with epinephrine; however, the motor block is less profound and of shorter duration.
-
Regional anesthesia · Jul 1990
Randomized Controlled Trial Comparative Study Clinical TrialEffects of oral and subarachnoid clonidine on spinal anesthesia with bupivacaine.
This study was designed to determine whether clonidine has analgesic properties, decreases the minimum alveolar concentration of inhalational anesthetics, or affects the quality and the duration of spinal anesthesia with bupivacaine. The comparative effects of oral and subarachnoid clonidine on spinal anesthesia with bupivacaine were studied in 36 patients scheduled for orthopedic surgery. ⋯ Subarachnoid but not oral clonidine significantly prolonged the duration of sensory block (time for regression to L2 was 157 +/- 21 minutes in Group I and 267 +/- 75 minutes in Group II) and the duration of motor block (duration of Grade 3 motor block--Bromage scale--was 103 +/- 20 minutes in Group I and 175 +/- 68 minutes in Group II). Only the subarachnoid administration of clonidine achieves adequate concentrations to significantly increase the duration of spinal anesthesia.
-
Acta Anaesthesiol Scand · Jul 1990
Randomized Controlled Trial Comparative Study Clinical TrialPost-dural puncture headache in young patients. A comparative study between the use of 0.52 mm (25-gauge) and 0.33 mm (29-gauge) spinal needles.
In a prospective study of 80 patients under 40 years of age, given spinal anaesthesia through either a 0.52 mm (25-gauge) needle or a 0.33 mm (29-gauge) needle, the incidence of post-dural puncture headache and backache was compared. There were no headaches in the 0.33 mm needle group, while in the 0.52 mm needle group an incidence of 25% was found. ⋯ The technique of performing spinal anaesthesia was evaluated and concluded to be slightly more difficult with a 0.33 mm needle, as estimated by the number of redirections of the needle needed to obtain cerebrospinal fluid. There were no differences between the two needles with respect to obtaining adequate spinal anaesthesia and spread of blockade.
-
Acta Anaesthesiol Scand · Jul 1990
Randomized Controlled Trial Comparative Study Clinical TrialRandomized comparison of recovery after propofol-nitrous oxide versus thiopentone-isoflurane-nitrous oxide anaesthesia in patients undergoing ambulatory surgery.
A randomized, prospective study was performed to compare recovery characteristics in 41 ASA physical status I-II patients scheduled for ambulatory surgery with either propofol or thiopentone-isoflurane anaesthesia. Particular attention was focused on the recovery time needed to meet discharge criteria. The propofol group received propofol 2 mg.kg-1 for induction followed by propofol infusion (6-9 mg.kg-1.h-1) 1 min after intubation. ⋯ The propofol group had significantly (P less than 0.05) faster clinical recovery than the isoflurane group with respect to times to response to commands, eye opening, orientation, ability to stand and void, tolerance to oral fluids, "home-readiness", and recovery of perceptual speed. Patients in the propofol group had significantly less (P less than or equal to 0.05) emesis than the patients given isoflurane. We conclude that in patients undergoing ambulatory surgery propofol infusion is preferable to thiopentone-isoflurane anaesthesia, because it may allow faster discharge home.
-
Acta Anaesthesiol Scand · Jul 1990
Randomized Controlled Trial Comparative Study Clinical TrialThe influence of pancuronium and vecuronium combined with balanced anaesthesia on haemodynamics and myocardial oxygen balance.
The effects of the non-depolarizing muscle relaxants pancuronium (Pancuronium) and vecuronium (Norcuron) (0.1 mg/kg) on myocardial blood flow, myocardial oxygen consumption, myocardial lactate balance, cardiovascular dynamics and electrocardiogram were studied in two groups of eight patients undergoing coronary artery bypass surgery. After induction of anaesthesia with 0.015-0.02 mg/kg flunitrazepam, isoflurane (0.5 vol%) and N2O/O2 (l/l), neuromuscular blockade was induced with pancuronium or vecuronium (0.1 mg/kg) combined with a single dose of 0.005 mg/kg fentanyl. Haemodynamic measurements were performed and the electrocardiogram was recorded before anaesthesia, in steady-state anaesthesia, after relaxation with pancuronium or vecuronium combined with fentanyl, and after intubation. ⋯ None of the other haemodynamic parameters differed significantly in either patient group. We did not observe ST-segment depressions or elevations in the ECG, increases in PCWP or myocardial lactate production. Therefore extended myocardial ischaemia can be excluded in our patients who received pancuronium or vecuronium for neuromuscular blockade.