Articles: anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Spinal anaesthesia with 0.5% bupivacaine 3 ml: comparison of plain and hyperbaric solutions administered to seated patients.
In a double-blind study, 0.5% bupivacaine 3 ml in plain (n = 10) or hyperbaric (n = 10) solution was injected intrathecally to 20 patients who were in the sitting position, to produce spinal anaesthesia for transurethral resection of prostate. No statistically significant differences were found in time to maximum cephalad spread of analgesia nor in the level reached. ⋯ There was no difference in the incidence of complete motor block, but a longer duration of lesser degrees of motor block was found with the plain solution (P less than 0.05). The plain solution produced a more predictable level of blockade.
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Acta Anaesthesiol Scand · Oct 1988
Randomized Controlled Trial Clinical TrialLower limb compression using inflatable splints to prevent hypotension during spinal anaesthesia for caesarean section.
The efficacy of pneumatic compression of the lower limbs using inflatable leg splints in prevention of hypotension during spinal anaesthesia was assessed in an open study of 46 patients undergoing elective caesarean section. All patients received 15 ml/kg of Hartmann's solution before spinal anaesthesia and were tilted to the left to minimise aortocaval compression. ⋯ Blood pressure was measured by a cuff method at 1-min intervals until the commencement of surgery. Hypotension was less common (P less than 0.05) and less severe (P less than 0.05) in splint-treated patients, but the incidence was unacceptably high in both treated (48%) and control (83%) groups.
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Anasth Intensivther Notfallmed · Oct 1988
Randomized Controlled Trial Comparative Study Clinical Trial[The effect of atropine, fentanyl and alfentanyl on cardiocirculatory parameters and thoracic rigidity in the induction phase of intubation anesthesia].
Fentanyl and alfentanil may cause bradycardia if used in combination with succinylcholine during induction of anaesthesia. We therefore studied the influence of atropine, fentanyl and alfentanil on the haemodynamics of 90 urological patients (ASA I, II), who were allocated at random to six groups containing 15 patients each. Induction of anaesthesia was carried out using atropine 0.01 mg/kg-1, fentanyl 0.15 mg or alfentanil 1.5 mg depending on the assigned group: I atropine + fentanyl, II: atropine + alfentanil, III: fentanyl, IV: alfentanil, V: control (no atropine, no analgetic), VI: atropine. ⋯ Arrhythmias occurred in the groups with atropine in 4 out of 45 cases, while a chest wall rigidity was not influenced by atropine. Bradycardia occurred after fentanyl or alfentanil with atropine in the same frequency as without atropine. According to our results the routine use of atropine for induction of anaesthesia with thiopentone/fentanyl or alfentanil even in combination with succinylcholine is not required in ASA I or II patients.
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J Cardiothorac Anesth · Oct 1988
Randomized Controlled TrialInfluence of beta-blockers on vecuronium/sufentanil or pancuronium/sufentanil combinations for rapid induction and intubation of cardiac surgical patients.
Use of pancuronium or vecuronium with the priming principle was evaluated in regards to hemodynamic changes and adequacy of relaxation for a rapid induction-endotracheal intubation sequence with sufentanil in 24 ASA Class III-IV patients undergoing cardiac surgery. Twelve patients taking beta-blockers (groups B-P and B-V) were compared with 12 patients not receiving beta-blockers (groups NB-P and NB-V). Patients randomly received vecuronium or pancuronium (15 microg/kg), followed in 4 minutes by sufentanil 5 microg/kg and another 85 microg/kg of the appropriate relaxant through a central vein. ⋯ Chronic beta-blocker therapy was able to attenuate the tachycardia from pancuronium and was not associated with bradycardia when used with vecuronium. In patients with cardiac disease not on beta-blockers, pancuronium was associated with tachycardia. Therefore, vecuronium appears to be more suitable for these patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
Maternal inspired oxygen concentration and neonatal status for caesarean section under general anaesthesia. Comparison of effects of 33% or 50% oxygen in nitrous oxide.
The relationship between maternal FIO2 and umbilical venous PO2, PCO2, pH and neonatal Apgar and TSR (time to sustained respiration) scores was studied in 35 patients undergoing Caesarean section under general anaesthesia. Patients were allocated randomly to breathe an FIO2 of either 0.5 or 0.33. ⋯ No differences were found between groups for 1- or 5-min Apgar scores or TSR values. It is concluded that no difference in fetal outcome or acid-base status can be detected when maternal FIO2 is decreased from 0.5 to 0.33, and that the use of 33% oxygen in 66% nitrous oxide appears to be safe for neonates who have not suffered fetal distress before delivery.