Articles: anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cardiovascular effects of fibrescope-guided nasotracheal intubation.
The cardiovascular effects of fibrescope-guided nasotracheal intubation were compared to those of a control group of patients who were intubated using the Macintosh laryngoscope. The 60 patients studied received a standard anaesthetic technique which included a muscle relaxant and were allocated randomly to one of two groups immediately before tracheal intubation. Systolic and diastolic arterial pressures in the fibreoptic group were significantly lower than in the control group during the first minute after intubation. ⋯ The heart rate in the fibreoptic group was significantly higher than in the control group during all five minutes after intubation. The maximum increase in heart rate was significantly higher in the fibreoptic group. The cardiovascular responses to fibreoptic nasotracheal intubation under general anaesthesia should not cause undue concern in fit patients, but appropriate measures should be taken to prevent excessive tachycardia in compromised patients.
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Anaesth Intensive Care · Nov 1989
Randomized Controlled Trial Comparative Study Clinical TrialPost-cholecystectomy pulmonary function following interpleural bupivacaine and intramuscular pethidine.
Twenty-four patients who were to undergo cholecystectomy were randomised into two groups, one to receive postoperative analgesia with interpleural bupivacaine, 20 ml of a 0.5% solution with adrenaline 5 micrograms/ml, and the other to receive intramuscular pethidine, 1 mg/kg. Preoperative and postoperative pulmonary function, postoperative pain scores, and days from operation to hospital discharge were recorded and statistically compared. There was no significant difference in pain scores, nor in days to discharge; however, postoperative pulmonary mechanics were significantly poorer in the interpleural group. A hypothesis to explain the differences is offered.
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J. Endocrinol. Invest. · Oct 1989
Randomized Controlled Trial Clinical TrialEffects of surgery and general or epidural anesthesia on plasma levels of cortisol, growth hormone and prolactin in infants under one year of age.
Twenty infants under one yr of age undergoing minor surgery were divided in two groups according to the type of anesthesia (epidural, Group 1, n = 10; general, Group 2, n = 10) which was randomly performed. Blood samples for cortisol (F), growth hormone (GH), and prolactin (PRL) determination were taken from each infant in baseline conditions, before surgery, and at the end of surgery. Mean plasma F levels in infants of group 2 rose significantly (p less than 0.01) before surgery to attend a maximum at the end of surgery (p less than 0.005). ⋯ Mean plasma PRL levels showed a significant increase before surgery (p less than 0.05 and p less than 0.01 in group 1 and 2, respectively) and a further increase at the end of surgery in both groups of infants (p less than 0.005). These results suggest that in infants under one yr of age both types of anesthetic procedures preceding surgery have no significant effect on plasma GH, but produce a significant increase of cortisol and prolactin mean plasma levels. The cortisol response to surgery and general or epidural anesthesia was similar to that reported in adults and prepubertal boys.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
[The effect of sufentanil in high doses on hemodynamics and electroencephalography activity in coronary patients].
Sufentanil, a synthetic opioid that is 5-10 times as potent as fentanyl, has been suggested by some authors to prevent hypertensive responses to noxious stimuli in patients undergoing coronary artery bypass surgery much better than fentanyl, while in other studies it has failed to maintain cardiovascular stability during surgical stimulation. This study was designed to investigate the cardiovascular and electroencephalographic effects of high-dose sufentanil/O2/pancuronium anesthesia in patients undergoing coronary artery bypass surgery. METHODS. ⋯ Cardiac and stroke volume indexes stayed significantly lower than the awake values, whereas heart rate remained essentially unchanged during the course of the study. There were no statistically significant differences between the groups during all measurements. In the EEG, sufentanil anesthesia was characterized by a decrease in the number of higher frequency waves and an increase in lower frequency (delta) waves, which did not change during sternotomy in 17 of the 20 patients.
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Randomized Controlled Trial Clinical Trial
Perioperative analgesia with subarachnoid fentanyl-bupivacaine for cesarean delivery.
Addition of fentanyl to bupivacaine administered for spinal anesthesia for cesarean delivery was evaluated in 56 ASA physical status 1 term parturients. Preservative-free saline was added to 0, 2.5, 5, 6.25, 12.5, 25, 37.5, or 50 micrograms fentanyl to make a 1 ml total volume, which was injected intrathecally prior to bupivacaine in a double-blind, randomized fashion. Vital signs, sensory level, motor block, pain score, and side effects were recorded every 2 min for the first 12 min and then at 15, 30, 45, and 60 min and at 30-min intervals until the patient complained of pain. ⋯ None of the patients who received greater than or equal to 6.25 micrograms fentanyl required intraoperative opioids. Complete analgesia (time from injection to first report of pain) lasted 33.7 +/- 30.8 min (mean +/- SD) in the control group and increased to 130 +/- 30 min (P less than 0.05) with addition of 6.25 micrograms fentanyl. Duration of effective analgesia (time from injection to first parenteral opioid) was 71.8 +/- 43.2 min in the control group and increased (P less than 0.05) to 192 +/- 74.9 min with addition of 6.25 micrograms fentanyl.(ABSTRACT TRUNCATED AT 250 WORDS)