Articles: anesthetics.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Continuous extradural infusion of ropivacaine for prevention of postoperative pain after major orthopaedic surgery.
We studied 151 patients undergoing total hip or knee arthroplasty, or cruciate ligament reconstruction in a multicentre study in Australia and New Zealand. Patients were openly allocated randomly to one of five treatment groups or to a control group. General anaesthesia was induced after introduction of extradural block with 0.5% ropivacaine. ⋯ The quality of treatment scores were similar for all treatment groups (Br. J. Anaesth. 1996; 76: 606-610).
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Anesthesia and analgesia · Mar 1996
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialThe comparative effects of sevoflurane versus propofol in the induction and maintenance of anesthesia in adult patients.
A randomized, prospective study was performed at four institutions to compare anesthetic induction, maintenance, and recovery characteristics between sevoflurane- and propofol-based anesthesia in 186 ASA physical status I and 11 patients undergoing elective surgical procedures of 1-3 h. Group 1 (n = 93) patients received sevoflurane-nitrous oxide for both induction and maintenance of anesthesia while Group 2 (n = 93) received propofol-nitrous oxide anesthesia. Induction of anesthesia and tracheal intubation times were significantly shorter with propofol (2.21 +/- 0.2 min, 5.11 +/- 0.3 min, respectively) than with sevoflurane (3.11 +/- 0.2 min, 7.21 +/- 0.3 min, respectively). ⋯ The incidence of postoperative nausea, vomiting, and pain-discomfort scores were similar between the two groups. Urinary specific gravity decreased in the sevoflurane-treated group while serum creatinine and urinary pH were unchanged from preoperative values in both groups. Sevoflurane compared favorably with propofol when used for anesthesia for elective procedures of 1-3 h duration.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
[The cardiovascular effects of sevoflurane].
The cardiovascular effects of sevoflurane as published from clinical and experimental studies are reviewed with respect to general haemodynamics and organ perfusion. Sevoflurane appears to be quite similar to isoflurane, with some minor exceptions. In adult patients and volunteers, sevoflurane has not been associated with increases in heart rate, whereas isoflurane and desflurane caused significant increases in heart rate at higher concentrations. ⋯ In several multi-center studies where patients with coronary artery disease or at high risk for coronary artery disease were randomised to receive either sevoflurane or isoflurane for cardiac or non-cardiac surgery, the incidence of myocardial ischaemia and infarction did not differ between treatment groups. In both human and animal models, sevoflurane preserves cerebral blood flow and reduces cerebral metabolic rate much like isoflurane. Considering its favourable pharmacokinetic properties, the introduction of sevoflurane into clinical practice appears to be a promising extension of the anaesthetic spectrum.
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Randomized Controlled Trial Multicenter Study Clinical Trial
[Comparison of sevoflurane and isoflurane in ambulatory surgery. Results of a multicenter study].
A multicenter, randomized, comparative phase III study evaluating the effect of sevoflurane versus isoflurane in adult outpatients was performed. The aim of the study was to compare (1) maintenance of anaesthesia and (2) how rapidly and easily the patients emerge from the anaesthetic and recover. ⋯ Sevoflurane was as safe as isoflurane for anaesthesia in adult outpatients. Patients who received sevoflurane had statistically significantly shorter recovery parameters than isoflurane patients.
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Paediatric anaesthesia · Jan 1996
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA comparison of sevoflurance to halothane in paediatric surgical patients: results of a multicentre international study.
Induction, emergence and recovery characteristics were compared during sevoflurane or halothane anaesthetic in a large (428) multicentre, international study of children undergoing elective inpatient surgical procedures. Two hundred and fourteen children in each group underwent inhalation induction with nitrous oxide/oxygen and sevoflurane or halothane. Incremental doses of either study drug were added until loss of eyelash reflex was achieved. ⋯ Mean maximum inorganic fluoride concentration was 18.3 microM.l-1. The fluoride concentrations peaked within one h of termination of sevoflurane anaesthetic and returned rapidly to baseline within 48 h. This study suggests that sevoflurane may be the drug of choice for the anaesthetic management of children.