Articles: anesthesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Effect of naloxone on the loss of consciousness induced by i.v. anaesthetic agents in man.
The effect of a specific opioid antagonist, naloxone, was studied in two comparable groups of patients who received i.v. the dose of an anaesthetic agent required to produce loss of consciousness in 50% of subjects. The first group received naloxone 0.006 mg kg-1 5 min before induction of anaesthesia; the second group received a similar volume of saline solution. ⋯ The differences in percentage of unconscious patients between the naloxone-treated group and the control group were statistically significant for diazepam, ketamine and propanidid. Naloxone did not modify the induction of anaesthesia with thiopentone or Althesin.
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Anesthesia and analgesia · Apr 1984
Randomized Controlled Trial Comparative Study Clinical TrialComparison of four opioid analgesics as supplements to nitrous oxide anesthesia.
The hemodynamic changes, plasma norepinephrine levels, pupil size, and rapidity of postoperative mental recovery were measured and compared in 72 patients randomly assigned in a double-blind manner to receive either morphine, meperidine, fentanyl, or sufentanil as supplements to nitrous oxide anesthesia. Meperidine, unlike the other opioids, which did not change heart rate, consistently increased it. Hemodynamic responses to laryngoscopy and intubation were suppressed by fentanyl and sufentanil, but not by morphine or meperidine. ⋯ Meperidine caused deleterious effects on objective tests of psychomotor and cognitive skills that were not reflected by subjective evaluation of rate of recovery from anesthesia. The authors conclude that moderate doses of fentanyl and sufentanil are better supplements to nitrous oxide anesthesia than morphine or meperidine and that fentanyl and sufentanil are equally satisfactory. Subjective effects of the opioids correlated well with changes in pupil diameter.
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Acta Anaesthesiol Scand · Apr 1984
Randomized Controlled Trial Comparative Study Clinical TrialFailure of epidural analgesia to modify postoperative depression of delayed hypersensitivity.
Delayed hypersensitivity to four common antigens was assessed in 32 patients undergoing major abdominal surgery randomly allocated to either general anesthesia (fentanyl + O2/N2O + postoperative pain relief with systemic opiates) or general anaesthesia + epidural analgesia (local anaesthetics + morphine) continued for 72 h. Skin-test responses were performed 2 days before surgery and 1 day after surgery and compared to a similar retesting schedule in 16 comparable non-operative control patients. ⋯ In contrast, mean skin-test responses in patients operated during general anaesthesia + systemic opiates for postoperative pain relief fell from 1422 to 1227 mm2 (P = 0.3) and in patients receiving epidural analgesia from 1228 to 890 mm2 (P = 0.06), without statistically significant differences between these two groups (P greater than 0.5). Thus, surgery leads to depression of delayed hypersensitivity and this impairment in immunofunction is not modified by an epidural analgesic regimen providing adequate pain relief.
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Randomized Controlled Trial Comparative Study Clinical Trial
The effect of phenoxybenzamine on postoperative urinary complications during extradural morphine analgesia.
One hundred and fifty patients, post-Caesarean section, were investigated to evaluate the effect of epidural morphine analgesia and that of phenoxybenzamine on the frequency and extent of urinary complications. Forty patients (group A) underwent Caesarian section under general anaesthesia, while 110 patients received epidural anaesthesia. Of the latter patients, 40 received postoperative mild analgesics (group B) whilst in another 40, postoperative continuous epidural morphine was administered (group C). ⋯ The need for bladder catheterization was also increased in group B compared with group A, while in group C this increase was marked compared with both groups A and B. It was significantly less frequent in those receiving phenoxybenzamine. Phenoxybenzamine is recommended in the prevention of postoperative urinary complications associated with epidural anaesthesia and epidural morphine analgesia.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of fentanyl and halothane supplementation to general anaesthesia on the stress response to upper abdominal surgery.
The stress response to surgery and anaesthesia was studied in 20 patients undergoing cholecystectomy or vagotomy and pyloroplasty. Patients were anaesthetized with thiopentone and nitrous oxide; 10 patients received supplements of 0.5-1.5% halothane and the others fentanyl (mean 17 micrograms kg-1). ⋯ The hyperglycaemic response in the halothane group was greater than in the fentanyl group. Plasma noradrenaline concentrations increased in the group receiving halothane, but did not increase significantly in the group receiving fentanyl.