Articles: anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of vecuronium by continuous infusion with either isoflurane or fentanyl-nitrous oxide anesthesia.
The average infusion rate and efficacy of vecuronium bromide continuous infusions for surgical relaxation in human subjects was evaluated. Nineteen adult patients requiring more than 120 min of neuromuscular blockade for surgery were randomized to receive either fentanyl-nitrous oxide (Group 1) or isoflurane-fentanyl-nitrous oxide (Group 2). Neuromuscular function was monitored using train-of-four evoked electromyography (EMG). ⋯ An infusion of vecuronium at an initial rate of 60.0 micrograms/kg/h was then started and adjusted to maintain the first twitch at 10% of control. The average infusion rate (total infusion dose divided by the duration of the infusion) was 57.2 +/- 14 micrograms/kg/h in Group 1 (n = 10) and 42.4 +/- 12 micrograms/kg/h (n = 9) in Group 2, approximately 25% less (p = 0.02). There was a significant decrease in the infusion rate with time in Group 1 (p = 0.02), but this decrease was not observed in Group 2.
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Acta Anaesthesiol Belg · Jan 1989
Randomized Controlled Trial Comparative Study Clinical TrialA contribution to the monitoring of neuromuscular blockade: an evaluation of the Datex Relaxograph.
The Datex Relaxograph is a neuromuscular transmission monitor, which measures the degree of neuromuscular blockade during anesthesia. In order to evaluate the reliability of the Relaxograph, results, obtained with this apparatus, were compared with simultaneous mechanical measurements obtained with the Myograph 2000 (Biometer). Although there was a good correlation between the two throughout the study, a shift towards mechanical responses was observed in all cases. ⋯ Results show that neither drug offers major clinical advantages over the other. In a third study, a new bolus-constant infusion regimen of atracurium was evaluated. Results show that it produces a predictable and stable neuromuscular blockade.
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Ann Fr Anesth Reanim · Jan 1989
Randomized Controlled Trial Clinical Trial[Comparison of blood pressure profiles with flunitrazepam/fentanyl/nitrous oxide vs cervical epidural anesthesia in surgery of the carotid artery].
A study was carried out to compare the evolution of arterial blood pressure during carotid endarterectomy performed under either general anaesthesia (GA) or cervical epidural anaesthesia (CEA). 20 patients were randomly assigned to two equal groups. In the CEA group, 15 ml of 0.375% bupivacaine and 150 micrograms fentanyl were injected into the epidural space at C7-D1 level. In the GA group, patients were anaesthetized with 0.2 mg.kg-1 flunitrazepam and 5 micrograms.kg-1 fentanyl; intubation was carried out using 0.08 mg.kg-1 vecuronium, and the patients were ventilated with a mixture of nitrous oxide and oxygen (50% of each). ⋯ Per- or postoperative hypertension was defined as a rise in systolic arterial blood pressure (Pasys) over 180 mmHg for greater than 3 min; this was treated with 20 mg nifedipine intranasally (group CEA) or 100 micrograms fentanyl with 0.5 mg flunitrazepam with or without nifedipine (group GA). Per- or postoperative hypotension was defined as a fall in Pasys below 100 mmHg and or a 30% fall in mean arterial blood pressure for greater than 3 min; this was treated, in both groups, with an intravenous bolus of 3 mg ephedrine. Patients in group CEA experienced more frequent episodes of peroperative hypertension (8/2; p less than 0.02) and postoperative hypotension (5/1) than group GA.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of propofol and thiamylal for induction and maintenance of anaesthesia for outpatient surgery.
In an open, randomized study we have compared the safety and efficacy of propofol with thiamylal for induction and maintenance of anaesthesia supplemented by nitrous oxide in elective termination of pregnancy. Induction of anaesthesia was achieved with either propofol 2.5 mg kg-1 or thiamylal 4.0 mg kg-1 followed by maintenance with 70% nitrous oxide in oxygen and repeat boluses of 25% of the induction dose i.v. as indicated clinically. ⋯ The patients in the propofol group were alert and orientated early in the postoperative period, with less nausea or vomiting. Propofol has properties that are of particular benefit in anaesthesia for ambulatory surgery.
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Randomized Controlled Trial Comparative Study Clinical Trial
Alkalinized bupivacaine and adrenaline for epidural caesarean section. A comparison with 0.5% bupivacaine.
Twenty-four mothers received either 0.5% bupivacaine (group 1, n = 14), or alkalinized 0.5% bupivacaine and 1 in 200,000 adrenaline (group 2, n = 10), as an epidural local anaesthetic for elective lower segment Caesarean section in a randomised, double blind study. The two groups were prepared for surgery according to an identical technique. Onset of analgesia to pinprick was significantly faster in group 2 (p less than 0.02). ⋯ Onset of motor blockade was significantly faster in group 2 (p = 0.01). There were no significant differences between the two groups with regard to duration of surgery, or Apgar scores at 1 and 5 minutes. Alkalinized 0.5% bupivacaine and adrenaline was superior to 0.5% bupivacaine for epidural Caesarean section.