Articles: anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
[A comparison of 7 types of epidural catheters].
The stiffness on bending of 7 types of epidural catheters was measured with the help of a cantilever beam. 1415 patients scheduled for lithotripsy, requiring epidural anesthesia, were selected and randomly assigned to receive one of the catheters. The patients were divided into 2 groups according to the resistance to insertion. The incidence of intravenous insertion, subarachnoid location and paresthesia during catheter insertion were assessed. ⋯ When the catheter was hard or pushed against the resistance to insertion, the incidence of paresthesia increased. When the catheter was hard and pushed against the resistance to insertion, transforaminal escape increased. A soft catheter should be chosen to minimize the incidence of paresthesia or transforaminal escape.
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Randomized Controlled Trial Clinical Trial
Is crystalloid preloading useful in spinal anaesthesia in the elderly?
Sixty ASA grade 1 or 2 patients, aged 60 years or over, scheduled for surgery to the lower abdomen or lower limbs under spinal anaesthesia were allocated randomly to one of three treatment groups. Group A received 16 ml/kg of Ringer's acetate solution immediately before spinal anaesthesia, group B received 8 ml/kg and group C received no volume preload. Heart rate, arterial pressure and anaesthetic level were recorded by an independent observer. ⋯ The overall incidence of hypotension was 60%, when temperature sensation was blocked to T7 and above (n = 25). The number of patients with hypotension which required treatment increased as block height increased above T7; at a level of T4 or higher, all patients required ephedrine. Crystalloid preloading had no effect on the incidence of hypotension after spinal anaesthesia in fit, elderly patients.
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Randomized Controlled Trial Clinical Trial
[Potentiation of nondepolarizing muscle relaxants by nifedipine iv in inhalation anesthesia].
Calcium entry blockers are now widely used in the treatment of cardiovascular diseases. Nifedipine is established for the treatment of perioperative hypertension during anesthesia. Previous animal experiments have demonstrated that calcium entry blockers potentiate the neuromuscular response induced by nondepolarizing blocking drugs. ⋯ Our results confirm previous assumptions of synergistic effects of neuromuscular blocking drugs and nifedipine in patients. This synergistic effect includes both duration and intensity of neuromuscular blockade. In the postoperative period patients may be endangered by nifedipine therapy if recovery from the neuromuscular depression is not complete.
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Anaesth Intensive Care · Feb 1990
Randomized Controlled Trial Comparative Study Clinical TrialA double-blind comparison of epidural bupivacaine and bupivacaine-fentanyl for caesarean section.
The effect of adding fentanyl 100 mcg to bupivacaine 0.5% plain to establish epidural anaesthesia for elective caesarean section was investigated in a randomised, double-blind study of sixty healthy women. The quality of intraoperative analgesia as assessed by both patients and anaesthetists was significantly improved with fentanyl. The onset and duration of sensory anaesthesia, degree and duration of motor block, and other characteristics of epidural anaesthesia were unaltered. ⋯ The pharmacokinetics of epidural fentanyl administration were investigated by plasma fentanyl assays from maternal and cord blood taken at delivery. Epidural bupivacaine-fentanyl combination is a valuable therapeutic approach to the conduct of epidural anaesthesia for caesarean section in healthy women and foetuses. Further neonatal evaluation of the premature or compromised foetus is suggested before the universal application of this technique.
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Anaesth Intensive Care · Feb 1990
Randomized Controlled Trial Clinical TrialGastric aspiration at the end of anaesthesia does not decrease postoperative nausea and vomiting.
Two hundred and one women undergoing elective abdominal hysterectomy were anaesthetised with isoflurane in nitrous oxide and oxygen. At the end of anaesthesia the stomach was aspirated in half of the patients, selected in random order. In the other half no aspiration was performed. ⋯ Emesis was similar after the operation regardless of aspiration of the stomach (overall emesis, 79% and 70% for those whose stomach had and had not been aspirated, respectively). The incidence at all times during the 24 hours was similar in both groups. The results suggest that gastric aspiration at the end of anaesthesia has no major effect on the incidence or severity of postoperative emesis in patients undergoing abdominal hysterectomy.