Articles: anesthetics.
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Randomized Controlled Trial Clinical Trial
Hypnotic and anaesthetic action of thiopentone and midazolam alone and in combination.
This study examined the interaction between i.v. administered midazolam and thiopentone on the loss of response to verbal command ("hypnosis") and the loss of response to transcutaneous electrical stimulation of the ulnar nerve ("anaesthesia") in patients presenting for minor elective surgery. Dose-response curves for thiopentone and midazolam individually and in combination were determined using the two end-points in 300 unpremedicated patients. ⋯ Although midazolam failed to produce anaesthesia in the dose range used, the dose of thiopentone required to produce anaesthesia was reduced by 50% in the presence of midazolam. The mechanism of interaction and the potential role of benzodiazepine-barbiturate combinations are discussed and the observed synergistic anaesthesia interaction is used to explain the potentially dangerous combination of benzodiazepines with other potent CNS depressants such as barbiturates and alcohol.
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Knowledge of the influence of anesthetics on cerebral blood flow and metabolism is the key to both safe neuroanesthesia practice and understanding the possible neuroprotection offered by these agents. In this paper the authors summarize recent data from the literature. All volatile anesthetics (except for nitrous oxide) produce a dose dependent decrease in cerebral metabolism. ⋯ Autoregulation is preserved during the administration of propofol. The effects of narcotic agents depend largely on the background anesthetic. Pathological conditions induced physiologic changes, and coadministration of other drugs can greatly alter the effects of anesthetics on the brain.
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Randomized Controlled Trial Comparative Study Clinical Trial
Buffered versus plain lidocaine as a local anesthetic for simple laceration repair.
Buffered lidocaine was compared with plain lidocaine as a local anesthetic for simple lacerations. ⋯ Buffered lidocaine is preferable to plain lidocaine as a local anesthetic agent for the repair of simple lacerations.
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Randomized Controlled Trial Clinical Trial
Efficacy of tetracaine-adrenaline-cocaine topical anesthetic without tetracaine for facial laceration repair in children.
To determine whether the tetracaine component traditionally used in tetracaine-adrenaline-cocaine (TAC) is necessary to obtain effective topical anesthesia, a prospective study was performed to compare TAC and adrenaline-cocaine preparations for the repair of facial lacerations in children. Physicians were "blind" to which preparation was being used. ⋯ The tetracaine component of TAC is superfluous for obtaining topical anesthesia of minor dermal lacerations of the face in children. The TAC formulation can be simplified by omitting tetracaine without compromising anesthetic efficacy.