Articles: anesthesia.
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Randomized Controlled Trial Clinical Trial
Local application of EMLA and glyceryl trinitrate ointment before venepuncture.
One hundred unpremedicated fit day surgery patients aged between 27 and 68 years were allocated randomly into one of four groups and EMLA, glyceryl trinitrate, EMLA and glyceryl trinitrate or a placebo ointment was applied to the dorsum of a hand. The pain and ease of venepuncture were determined at induction of anaesthesia 60 minutes later. Pain scores were also reassessed 1-2 hours after operation. Lower pain scores and easier venepuncture occurred when EMLA and glyceryl trinitrate ointment was applied to the dorsum of the hand.
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Randomized Controlled Trial Comparative Study Clinical Trial
End-tidal concentrations of halothane and isoflurane during induction of anaesthesia in young and elderly patients.
Twenty-two young (18-32 yr) and 22 healthy elderly (60-80 yr) patients received either halothane or isoflurane for maintenance of anaesthesia during controlled ventilation. End-tidal fractional concentrations (FE) of the agents were measured for 20 min after their introduction into inspired gas and the increase in end-tidal concentrations of the two agents was compared during induction of anaesthesia using the ratios of FE to the inspired fraction (FI). ⋯ This suggests slower induction of anaesthesia in the elderly if equipotent concentrations of isoflurane are used; the clinical significance of this difference is probably small. Mean FE:FI ratios for halothane in elderly patients were similar to those in the young throughout induction of anaesthesia.
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Gynecol. Obstet. Invest. · Jan 1990
Randomized Controlled Trial Clinical TrialPrevention of a side effect of epidural morphine by epidural steroid administration in cesarean section.
In order to evaluate the effect of preventive corticosteroid on the occurrence of pruritus after epidural anesthesia with morphine, we studied 95 patients undergoing cesarean section. Thirty-seven patients (group I) were given 20 mg of bupivacaine 0.5% for the operation and 2 mg of morphine hydrochloride with 50 mg of Ultracortene-H immediately after the operation and 24 h later, and 58 patients (group II) were given epidural bupivacaine during the operation and epidural morphine hydrochloride immediately after the operation and 24 h later without Ultracortene-H. Only 8.1% of group I patients had pruritus after the injection compared to 20.6% in group II. We suggest that the addition of 50 mg Ultracortene-H to 2 mg epidural morphine analgesia after the operation might prevent severe forms of pruritus.
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Ann Fr Anesth Reanim · Jan 1990
Randomized Controlled Trial Comparative Study Clinical Trial[Alkalization of bupivacaine in the combination fentanyl-bupivacaine in epidural obstetrical analgesia].
A randomized double blind study was carried out to determine whether alkalization of a 0.25% bupivacaine solution in a fentanyl-bupivacaine mixture hastened the onset, and increased the duration and quality, of extradural analgesia during labour. The study included 120 women with uncomplicated full-term gestation. Prior to the extradural injection, 0.1 ml of either 8.4% sodium bicarbonate or normal saline was randomly added to 20 ml of 0.25% bupivacaine. ⋯ There were no statistically significant differences between the bicarbonate and control groups with regard to the speed of onset of analgesia (7.08 +/- 0.7 min vs. 6.78 +/- 0.6 min), its duration (123.6 +/- 10.7 min vs. 113 +/- 6.6 min), and the number of cases of inadequate pain relief (6 and 3 respectively). The rate of maternal adverse effects, and neonatal status, were similar in both groups. It can be concluded that alkalizing a 0.25% bupivacaine solution in a fentanyl-bupivacaine mixture for epidural analgesia in labour has no clinical value.
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Case Reports Randomized Controlled Trial Clinical Trial
[Comparison of adrenaline and clonidine to extend the analgesic effect of bupivacaine without glucose in spinal anesthesia].
So as to determine the effects of adrenaline and clonidine on the duration of isobaric bupivacaine spinal anaesthesia, a prospective controlled study was carried out on 20 ASA I or II patients. They were randomly allocated to two groups. The patients of group I were given 4 ml of a mixture including 3 ml of 0.5% bupivacaine, 0.2 mg adrenaline. ⋯ Regression times were 520.70 +/- 79.52 min for group II and 360.40 +/- 51.47 min. for group I. Significant prolongation of motor block was also associated with the addition of vasoconstrictors. It is concluded that addition of 0.15 mg clonidine may be useful to increase duration of isobaric bupivacaine spinal anaesthesia.