Articles: anesthesia.
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Ann Fr Anesth Reanim · Jan 1986
Randomized Controlled Trial Comparative Study Clinical Trial[Maintenance of obstetrical analgesia by continuous perfusion into the peridural space].
Two methods of epidural analgesia were compared in two randomized groups each of 16 normal women in labour, using bolus or continuous infusion. Analgesia was provided by a mixture of bupivacaine 0.25% and fentanyl. ⋯ There was no statistical difference between the two groups concerning length of labour, number of forceps, Apgar score and patient, obstetrician and anaesthetist satisfaction score. Although continuous epidural infusion was greatly appreciated by the obstetrical team, it would seem to be of interest only when labour is long enough to require larger doses, especially when labour is induced.
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Ann Fr Anesth Reanim · Jan 1986
Randomized Controlled Trial Clinical Trial[Spinal anesthesia with bupivacaine for surgery of the hip in the elderly].
In 60 elderly patients, spinal anaesthesia for orthopaedic hip surgery was induced randomly with 15 mg bupivacaine 0.375% without glucose (Group I), 2.5% glucose (Group II) or 7.5% glucose (Group III), in 4 ml. The injection was made in the lateral position, and the patients turned supine immediately after. The onset, extent and duration of sensory and motor blockade, the cardiovascular effects and the quality of anaesthesia were evaluated. ⋯ It was suggested to take into account the more rapid infusion of lactated Ringer's solution (20 ml X kg-1) in Group III. Anaesthesia was satisfactory in 95% of patients in Group I and Group II, and 90% in Group III. Glucose-free bupivacaine produced a long-lasting blockade suitable for hip surgery of long duration.
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Br J Obstet Gynaecol · Jan 1986
Randomized Controlled Trial Clinical TrialBladder drainage for caesarean section under epidural analgesia.
Fifty patients undergoing elective caesarean section under epidural analgesia were randomized prospectively to be catheterized with an 'in-out' or an indwelling urethral catheter. Of the patients who had catheterization for the time of surgery alone 44% subsequently required recatheterization, whereas all patients with indwelling catheters voided spontaneously on their removal. The frequency of significant bacteriuria was the same in both groups.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of enflurane, halothane, and isoflurane for diagnostic and therapeutic procedures in children with malignancies.
The authors performed a randomized, prospective trial comparing enflurane, halothane, and isoflurane (each administered with nitrous oxide) to establish which inhaled anesthetic produced the fewest complications and the most rapid induction of anesthesia for children undergoing general anesthesia for diagnostic procedures as oncology outpatients. Sixty-six children, ranging from 8 months to 18 years, underwent a total of 124 anesthetics. Induction of anesthesia (time from placement of facemask to beginning of skin preparation) was faster with halothane (2.7 +/- 1.0 min, mean +/- SD, n = 46) than with enflurane (3.2 +/- 0.8 min, n = 43) or isoflurane (3.3 +/- 1.2 min, n = 35). ⋯ During the maintenance of, emergence from, and recovery from anesthesia, coughing occurred most frequently with isoflurane. During the recovery period, headache occurred most frequently with halothane (9%); there were no significant differences in the incidence of nausea, vomiting, hunger, or depressed effect. The authors conclude that the rapid induction and minimal airway-related complications associated with halothane anesthesia make it an excellent anesthetic agent for pediatric patients undergoing short diagnostic procedures.
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Randomized Controlled Trial Comparative Study Clinical Trial
[Vecuronium: onset of effect and intubation conditions in comparison to pancuronium and suxamethonium].
The onset of neuromuscular blockade following the i.v. injection of vecuronium and pancuronium 0.05, 0.08 or 0.1 mg/kg and suxamethonium 0.5 or 1.0 mg/kg was studied in 304 patients during induction of anaesthesia by means of the compound action potential derived from the adductor pollicis muscle, which was indirectly stimulated via the ulnar nerve. The intubation conditions 1-5 min after injection were assessed using a scoring system related to ease of laryngoscopy, movement of vocal cords and coughing, and reflex movements of extremities. Development of motor blockade was time- and dose-dependent. ⋯ Although suxamethonium acts the fastest and tracheal intubation can be achieved within 0.5-1.0 min, its use involves certain side effects and disadvantages. Vecuronium acts considerably faster than pancuronium and good or excellent intubation conditions are present within 2 min. Suxamethonium is no longer the muscle relaxant of choice for intubation except for crash intubation, e.g., in patients with a full stomach.