Articles: anesthetics.
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Anesthesia and analgesia · Aug 1996
Randomized Controlled Trial Multicenter Study Clinical TrialA multicenter evaluation of total intravenous anesthesia with remifentanil and propofol for elective inpatient surgery.
Remifentanil is a mu-opioid receptor agonist with a context sensitive half-time of 3 min and an elimination half-life < or = 10 min. This study sought to evaluate the efficacy of remifentanil and propofol total intravenous anesthesia (TIVA) in 161 patients undergoing inpatient surgery. Remifentanil 1 microgram/kg was given intravenously (i.v.) followed by one of two randomized infusion rates: small dose (0.5 micrograms.kg-1.min-1) or large dose (1 microgram.kg-1.min-1). ⋯ The most frequent adverse events were hypotension (systolic blood pressure [BP] < 80 mm Hg or mean BP < 60 mm Hg) during anesthesia induction (10% small-dose versus 15% large-dose group; P = not significant [NS]) and hypotension (27% small-dose versus 30% large-dose group; P = NS), and bradycardia (7% small-dose versus 19% large-dose group; P = NS) during maintenance. In conclusion, when combined with propofol 75 micrograms.kg-1.min-1, remifentanil 1 microgram/kg i.v. as a bolus followed by an infusion of 1.0 microgram.kg-1.min-1 effectively controls responses to tracheal intubation. After tracheal intubation, remifentanil 0.25-4.0 micrograms.kg-1.min-1 effectively controlled intraoperative responses while allowing for rapid emergence from anesthesia.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Induction, recovery, and safety characteristics of sevoflurane in children undergoing ambulatory surgery. A comparison with halothane.
Sevoflurane is an inhalational anesthetic with characteristics suited for use in children. To determine whether the induction, recovery, and safety characteristics of sevoflurane differ from those of halothane, the following open-labeled, multicenter, randomized, controlled, phase III study in children undergoing ambulatory surgery was designed. ⋯ Sevoflurane compared favorably with halothane. Early recovery after sevoflurane was predictably more rapid than after halothane, although this was not reflected in a more rapid discharge from the hospital. The incidence of adverse events was similar for both anesthetics. Clinically, the induction, recovery, and safety characteristics of sevoflurane and halothane are similar. Sevoflurane is a suitable alternative to halothane for use in children undergoing minor ambulatory surgery.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A comparison of the recovery characteristics of sevoflurane and halothane in children.
The recovery characteristics of sevoflurane and halothane anaesthesia were compared in 40 children aged 6 months to 6 years undergoing day case surgery. The mean time taken to open eyes after surgery had ended was appreciably and significantly shorter after sevoflurane than after halothane (sevoflurane, mean time (SD) 7 min 52 s (5 min 46 s), halothane, mean time (SD) 15 min 50 s (9 min 2 s), t = 3.32, p = 0.002). ⋯ However, more children were in pain and given analgesia after sevoflurane (p < 0.01) and the mean time to reach the criteria for discharge home was similar in both groups (sevoflurane, mean time (SD) 2 h 9 min (17 min), halothane, mean time (SD) 2 h 4 min (8 min)). There were no major complications in either group.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A comparison of the induction characteristics of sevoflurane and halothane in children.
The induction characteristics of sevoflurane and halothane were compared in 81 children aged 6 months to 6 years. The mean time taken to achieve loss of eyelash reflex was significantly shorter with sevoflurane than with halothane (sevoflurane, mean time (SD) 1 min 41 s (35 s), halothane, mean time (SD) 2 min 17 s (43 s), t = 4.11, p = < 0.01). ⋯ Effects on heart rate, blood pressure and oxygen saturation during induction were similar for both agents. There were no major complications during induction with either halothane or sevoflurane.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
A double-blind comparison of ropivacaine 0.5%, 0.75%, 1.0% and bupivacaine 0.5%, injected epidurally, in patients undergoing abdominal hysterectomy.
Ropivacaine is a new long-acting, injectable local anaesthetic currently undergoing clinical investigation world wide. It is structurally very similar to bupivacaine, but with less potential for central nervous system or cardiac toxicity. The purpose of this double-blind study was: to investigate the dose-response relationship of increasing doses of ropivacaine on the quality of anaesthesia and the duration of both motor and sensory blockade, and to compare these results with an established local anaesthetic, bupivacaine. ⋯ Increasing doses of ropivacaine were associated with an increased clinical effect. The most consistent differences occurred when ropivacaine 1.0% was compared with 0.5% and the least consistent between ropivacaine 0.5%, 0.75% and bupivacaine 0.5%. The main difference between ropivacaine 1.0% and bupivacaine was in sensory duration. No serious adverse events were reported.