Articles: anesthetics.
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Ann Fr Anesth Reanim · Jan 1998
Multicenter Study Clinical Trial[1% mepivacaine and axillary block: duration of the sensory and motor blockade].
To assess the duration of both sensory and motor blockade of brachial plexus with 40 mL 1% mepivacaine after axillary or midhumeral approach. ⋯ Mid humeral or axillary block with 40 mL of 1% mepivacaine is highly successful and provides efficient surgical anaesthesia for various surgical procedures of intermediary duration.
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Randomized Controlled Trial Multicenter Study Clinical Trial
A comparison of 2% and 1% formulations of propofol for the induction and maintenance of anaesthesia in surgery of moderate duration.
This study, conducted in 110 patients undergoing surgery of moderate duration, compared the pharmacodynamic equivalence, efficacy and safety of 1% and 2% formulations of propofol. Anaesthesia was induced with propofol 2 mg.kg-1 given over 40 s and supplementary bolus injections of propofol were given if needed. There were no significant differences between the groups in mean induction times, total induction doses of propofol, frequency and mean duration of apnoea, fentanyl requirements or mean recovery times (times to eyes opening and to orientation). ⋯ Discomfort on injection occurred in 40% and 52% of those given 1% (n = 55) and 2% (n = 55) propofol, respectively; there was no statistically significant group difference in severity. No major adverse effects were reported. This study showed that the 2% formulation has a similar safety and pharmacodynamic profile to the 1% formulation.
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Anesthesia and analgesia · Nov 1997
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA randomized, blind comparison of remifentanil and alfentanil during anesthesia for outpatient surgery.
We compared remifentanil, an esterase-metabolized opioid, with alfentanil as part of balanced anesthesia with at least 0.8% isoflurane during outpatient surgery in a randomized, double-blind trial. One hundred two patients received remifentanil, and 99 patients received alfentanil. Patients who received remifentanil experienced significantly fewer stress responses to surgical stimuli (52.9% and 65.7%, P < 0.05); significantly fewer remifentanil patients responded to skin closure (11% and 22%, P < 0.05) than patients who received alfentanil. Significantly more patients in the alfentanil group required extra analgesia compared with the remifentanil group (P < 0.05). Time to respond to verbal command was shorter for alfentanil than remifentanil (median 7 min vs 9 min), and times to spontaneous respiration (median 5 min vs 8 min), adequate respiratory rate (median 6 min vs 9 min), and tracheal extubation (median 6 min vs 9 min) were significantly shorter for alfentanil in comparison with remifentanil (P < 0.05). Remifentanil patients, however, showed significantly better recovery of psychomotor and psychometric function between 30 and 90 min after surgery (P < 0.05). The incidences of hypotension intraoperatively and shivering postoperatively were significantly higher with remifentanil. No unexpected or serious adverse events were recorded with remifentanil; however, one patient who received alfentanil experienced severe recurrent respiratory depression after surgery. The metabolic profile of remifentanil allowed better intraoperative analgesia without compromising recovery. ⋯ The pharmacological profile of remifentanil, a new opioid for use in anesthesia, suggests that rapid recovery will occur after its use. This study of 200 outpatients shows that the differences suggested from kinetic studies are not always borne out in clinical practice, although later recovery variables did, in fact, favor remifentanil.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Comparison of 0.25% ropivacaine and bupivacaine for epidural analgesia for labor and vaginal delivery.
Part 1: To measure ropivacaine levels in the mother and infant at delivery after continuous lumbar epidural infusion. Part 2: To compare epidural ropivacaine to epidural bupivacaine for labor analgesia in regard to effectiveness, motor blockade, and maternal and neonatal effects. ⋯ Both ropivacaine and bupivacaine produced excellent analgesia for labor with no major adverse effect on the mother or neonate.
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Rev Esp Anestesiol Reanim · Nov 1997
Randomized Controlled Trial Multicenter Study Clinical Trial[The utility of digital infiltration of mepivacaine and ketorolac in postoperative analgesia of the unilateral hallux valgus].
To determine whether locally injected ketorolac provides analgesia additional to that of mepivacaine, and also to prevent, diminish or delay the peripheral hypersensitivity response of postoperative pain. ⋯ Infiltration of 30 mg of ketorolac along with mepivacaine delays the appearance of postoperative pain and diminishes it in the first 24 hours after surgery to correct hallux valgus, in comparison with infiltration of mepivacaine alone plus intravenous ketorolac.