Articles: anesthesia.
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J Cardiothorac Anesth · Feb 1988
Randomized Controlled Trial Clinical TrialCatecholamine responses to anesthetic induction with fentanyl and sufentanil.
In a randomized study, the authors examined the changes in plasma epinephrine and norepinephrine concentrations associated with induction of anesthesia and surgery in 33 patients with good ventricular function undergoing elective coronary artery surgery. After premedication with morphine and scopolamine, patients received either fentanyl, 100 micrograms/kg (n = 16), or sufentanil, 15 micrograms/kg, (n = 17), intravenously (IV), over 10 minutes to induce anesthesia. Metocurine, 0.42 mg/kg, IV, produced muscle relaxation. ⋯ Induction-related changes in arterial pressure and pulmonary capillary wedge pressure were significantly correlated with changes in the logarithm of plasma norepinephrine concentration. Similar degrees of endogenous norepinephrine release appear to accompany induction with equipotent doses of fentanyl and sufentanil in patients premedicated with morphine and scopolamine. Norepinephrine release may influence the hemodynamic response to induction with narcotics.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Plasma cortisol in experimental anesthesia with halothane, enflurane, isoflurane and nitrous oxide].
The influence of anesthesia on plasma cortisol has most often been studied in connection with routine operations. To investigate the specific effects of modern inhalation anesthetics more accurately, we examined the specific effects of four inhalation anesthetics on human plasma cortisol during volunteer studies on the influence of anesthetics on the electroencephalogramm. METHODS. ⋯ Blood samples were taken 5 min prior to induction (I), after the attainment of steady-state MAC 1.0 (II), 35 min later at MAC 0.5 (III), 40 min later at MAC 1.0 with volatile anesthetic/N2O (IV), and 15 (V) and 35 (VI) min after the end of anesthesia. RESULTS. MAC 0.5 N2O produced a marked rise in mean plasma cortisol, from 64.2 micrograms/l to 164.5 micrograms/l.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
Reducing the risks of laryngoscopy in anaesthetised infants.
We have evaluated the use of oxygen insufflation during laryngoscopy with an Oxyscope laryngoscope blade compared to conventional laryngoscopy for maintenance of transcutaneous PO2 during intubation of anaesthetised, spontaneously breathing infants. Twenty healthy children aged between 1 and 24 months were anaesthetised with halothane in oxygen. Laryngoscopy and intubation were performed in a double-blind fashion using a Miller No. 1 Oxyscope blade either with or without oxygen insufflation. ⋯ Transcutaneous oxygen tension decreased by 7.1% (SD 6.1%) when oxygen insufflation was used, compared to 33.0% (SD 15.1%) without oxygen insufflation (p less than 0.0001). There were no significant differences in mean duration of laryngoscopy or patient age. We conclude that oxygen insufflation during laryngoscopy and intubation of spontaneously breathing, anaesthetised infants effectively minimises the decrease in transcutaneous oxygen tension from pre-laryngoscopy levels, and makes instrumentation of the airway safer.
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Acta Anaesthesiol Scand · Jan 1988
Randomized Controlled Trial Comparative Study Clinical TrialEpidural versus combined spinal epidural block for cesarean section.
In a controlled study a single segment combined spinal epidural (CSE) block was compared with epidural block for cesarean section. Thirty healthy parturients were randomly divided into two groups. In both groups a T4 block was aimed at. ⋯ Apgar scores, blood gases and neurobehavioural evaluation did not show any differences between the two groups of neonates. No postspinal headache was noted. CSE block appears to combine the reliability of spinal block and the flexibility of epidural block while minimizing their drawbacks.
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Ann Fr Anesth Reanim · Jan 1988
Randomized Controlled Trial Clinical Trial[Prolongation of spinal anesthesia with hyperbaric bupivacaine by adrenaline and clonidine in the elderly].
So as to determine the effects of vasoconstriction on the duration of hyperbaric bupivacaine spinal anaesthesia, a prospective controlled study was carried out on 80 ASA class II or III patients, aged 75 years or more, who were scheduled for spinal anaesthesia for lower limb surgery. They were randomly allocated to four groups, and were each given 3 ml (15 mg) of 0.5% bupivacaine in plain solution with 0.5 ml of 30% dextrose solution, together with 1 ml normal saline in group I, 0.15 mg clonidine in group II, 0.2 mg adrenaline in group III, and 0.4 mg adrenaline in group IV. All patients therefore received 4.5 ml of 0.33% bupivacaine solution in 3.3% dextrose solution. ⋯ Regression times tended to increase more with 0.4 mg than with 0.2 mg adrenaline. Significant prolongation of motor block was also associated with the addition of vasoconstrictors. It is concluded that addition of 0.15 mg clonidine or 0.4 mg adrenaline may be useful to increase duration of hyperbaric bupivacaine spinal anaesthesia in elderly patients.