Articles: anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Anesthesia for ophthalmic surgery in the elderly: the effects of clonidine on intraocular pressure, perioperative hemodynamics, and anesthetic requirement.
The effects of clonidine on intraocular pressure and perioperative cardiovascular variables were studied by a randomized double blind design in 80 elderly patients (ASA physical status I-III) scheduled for elective ophthalmic surgery under general anesthesia (GA) and local anesthesia (LA). Group 1 (n = 40), the control group, received diazepam po (0.1 mg.kg-1) 90-120 min prior to arrival to the operating room. Group 2 (n = 40) received clonidine po approximately 5 micrograms.kg-1 po at the same time. ⋯ Intraoperatively, a significantly higher incidence of hypertension (P less than 0.01) and tachycardia (P less than 0.05) were respectively observed in the LA subset and GA subset of the controls when contrasted with the corresponding subset of those receiving clonidine. Moreover, clonidine was more effective than diazepam as a premedication; in fact, satisfactory intraoperative sedation and cardiovascular stability were observed in 85% of the patients who received clonidine, and in 50% of those patients who did not receive clonidine (P less than 0.01). Thus, clonidine may represent a useful adjunct in the management of the aged patient in the setting of ophthalmic surgery.
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Anaesth Intensive Care · May 1988
Randomized Controlled Trial Comparative Study Clinical TrialEpidural anaesthesia for caesarean section: a comparison of 0.5% bupivacaine and 2% lignocaine both with adrenaline.
Thirty-eight women having caesarean section under epidural anaesthesia received either lignocaine 2% or bupivacaine 0.5% both with adrenaline 1:200,000 in a double-blind, randomised study. The time to establish satisfactory surgical anaesthesia, the volume required and the quality of analgesia as assessed by the anaesthetist, patient pain and discomfort scales and patient approval, were not significantly different. ⋯ Neonatal outcomes were uniformly good. Both local anaesthetics provided satisfactory epidural anaesthesia and neither proved to have a distinct advantage in the clinical setting of this study.
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Anesthesia and analgesia · May 1988
Randomized Controlled Trial Clinical TrialContinuous infusion epidural analgesia in labor: the effect of adding sufentanil to 0.125% bupivacaine.
The purpose of this study was to determine if the addition of sufentanil would improve the quality of analgesia obtained with 0.125% epidural bupivacaine infusions given to women in active labor. Forty healthy laboring women were randomly assigned to two equal groups. Group 1 had epidural analgesia instituted with the bolus injection of 10-15 ml 0.125% bupivacaine containing sufentanil 2 micrograms/ml, followed 30 minutes later by initiation of an epidural infusion of 0.125% bupivacaine containing sufentanil 1 microgram/ml at a rate of 10 ml/hr. ⋯ Analgesia assessed by visual analog pain scores was significantly better in group 1. Significantly fewer epidural injections were required in group 1, and less motor weakness occurred in these patients. The addition of sufentanil to epidural bupivacaine infusions given in labor improves analgesia and reduces "top-up" requirements.
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Randomized Controlled Trial Comparative Study Clinical Trial
Continuous epidural infusion of 0.075% bupivacaine for pain relief in labour. A comparison with intermittent top-ups of 0.5% bupivacaine.
Seventy-three women who requested epidural analgesia during labour were randomly allocated in a prospective study to receive either a continuous epidural infusion of 0.075% bupivacaine at a rate of 12-18 ml/hour (38 mothers) or intermittent top-ups of 0.5% bupivacaine (35 mothers). Both groups received an initial dose of 6-8 ml bupivacaine 0.5%. ⋯ The quality of analgesia in the continuous infusion group was significantly better than in the intermittent top-up group (p less than 0.025). There was no significant difference in the total dose of bupivacaine given to the two groups.
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Acta Anaesthesiol Scand · Apr 1988
Randomized Controlled Trial Comparative Study Clinical TrialRespiratory effects of nitrous oxide during halothane or enflurane anaesthesia in children.
The respiratory effects of nitrous oxide (N2O) were studied during halothane and enflurane anaesthesia in 12 children (mean age 46.4 +/- 29.3 months, mean weight 15.3 +/- 4.2 kg) during surgery under continuous extradural anaesthesia. Four equipotent anaesthetic states were studied in random order: 1) halothane 1 MAC in oxygen, 2) halothane 0.5 MAC + 50% N2O, 3) enflurane 1 MAC in oxygen, 4) enflurane 0.5 MAC +50% N2O. End-tidal fractions of CO2 (PetCO2) and halothane and enflurane were measured using infrared analysers. ⋯ During enflurane anaesthesia, PetCO2 was less increased when N2O was substituted for enflurane, owing to a significant increase in respiratory frequency. A marked decrease in VE together with an increase in PetCO2 was observed during enflurane anaesthesia (states 3 and 4) when compared to the corresponding states during halothane anaesthesia (states 1 and 2). The respiratory depressant effect of enflurane is greater than that of halothane in unpremedicated children, even when substituting N2O for an equal MAC fraction of enflurane.2+ The effect of N2O on respiratory patterns seems to depend on the inhalational agent used and/or on the vesting respiratory frequency.