Articles: anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Epidural analgesia with a bupivacaine-fentanyl mixture in obstetrics: comparison of repeated injections and continuous infusion.
We compared the efficacy and side-effects of continuous infusion versus repeated injections of epidural bupivacaine-fentanyl during labour. Forty-four parturients were randomly distributed into two groups balanced for population size, morphology and parity. Analgesia was begun at the same stage of labour with a mixture of 20 ml 0.25 per cent plain bupivacaine and 2 ml (100 micrograms) fentanyl. ⋯ The course of labour, and maternal and neonatal status were comparable in the two groups. Assays showed no difference in bupivacaine blood concentrations between the two groups nor signs of drug accumulation. The constant infusion technique is advantageous since it provides a more regular degree of analgesia with lower doses than those required for patients having repeated injections.
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Anesthesia and analgesia · Mar 1988
Randomized Controlled Trial Clinical TrialPostoperative effects of intrathecal morphine in coronary artery bypass surgery.
To determine whether intrathecal morphine is effective in decreasing analgesic and antihypertensive drug requirements after coronary artery bypass (CAB) surgery, a prospective, randomized, double-blind study was designed. Approximately 30 minutes before induction of anesthesia with IV sufentanil and diazepam, and 2 hours before heparinization, one group of patients (n = 16) were given morphine 0.5 mg, while the control group (n = 14) were given placebo intrathecal injections through 22- or 25-gauge lumbar puncture needles. Intraoperatively, there were no differences in the numbers of patients requiring vasodilator drugs or volatile agent titration. ⋯ There were no differences in pain scores, and the only complications (itching, nausea and vomiting) were infrequent. It is concluded that an intrathecal dose of 0.5 mg of morphine is efficacious in reducing analgesic and antihypertensive drug requirements after CAB surgery. Whether these results are clinically important enough to warrant the theoretical risks of postheparinization lumbar hematoma is a topic for further investigation.
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Ann R Coll Surg Engl · Mar 1988
Randomized Controlled Trial Comparative Study Clinical TrialComparative evaluation of general, epidural and spinal anaesthesia for extracorporeal shockwave lithotripsy.
The results of a prospective randomised evaluation of general anaesthesia (GA), epidural anaesthesia (EA) and spinal anaesthesia (SA) for extracorporeal shockwave lithotripsy are presented. GA provided speed and reliability but resulted in a high incidence of postoperative nausea, vomiting and sore throat. ⋯ A major drawback associated with the use of SA was a 42% incidence of postspinal headache. All three techniques were associated with hypotension on placement in the hoisl; bath immersion resulted in significant rises in blood pressure in the EA and SA groups and a more variable (overall non-significant) response in the GA group.
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Randomized Controlled Trial Clinical Trial
[Propofol infusion for the maintenance of short-term anesthesia].
The administration of propofol by infusion for maintenance of anesthesia has attracted much attention recently. We investigated the necessary infusion rate of propofol to maintain anesthesia for short surgical procedures without loss of the evident advantages of this substance. Forty unpremedicated female patients aged 18-59, scheduled for minor gynecological procedures, were randomly assigned to four groups. ⋯ After induction, arterial blood pressure decreased by systolic/diastolic 20/10-15 mmHg. With the low infusion rate, arterial pressure increased to its control value during operation; it remained at the postinduction value with high infusion rates. Side-effects: 10 patients had salivation that in some instances lead to coughing, 9 reported pain at the injection site during induction, and 9 reported dreams of a pleasant nature.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
Cannulation of the epidural space. A comparison of 18- and 16-gauge needles.
A group of 685 obstetric patients were randomly allocated to have their epidural block performed using either a 16-gauge or an 18-gauge Tuohy needle. Bleeding was noted from needle or catheter trauma in 18% of patients and it proved impossible to insert the catheter in 3%. ⋯ Epidural analgesia, although safe, is not without hazard. It may be difficult to perform and may, rarely, cause considerable discomfort.