Articles: anesthetics.
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Randomized Controlled Trial Clinical Trial
[Propofol infusion for the maintenance of short-term anesthesia].
The administration of propofol by infusion for maintenance of anesthesia has attracted much attention recently. We investigated the necessary infusion rate of propofol to maintain anesthesia for short surgical procedures without loss of the evident advantages of this substance. Forty unpremedicated female patients aged 18-59, scheduled for minor gynecological procedures, were randomly assigned to four groups. ⋯ After induction, arterial blood pressure decreased by systolic/diastolic 20/10-15 mmHg. With the low infusion rate, arterial pressure increased to its control value during operation; it remained at the postinduction value with high infusion rates. Side-effects: 10 patients had salivation that in some instances lead to coughing, 9 reported pain at the injection site during induction, and 9 reported dreams of a pleasant nature.(ABSTRACT TRUNCATED AT 250 WORDS)
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The effects of propofol on cerebrospinal fluid pressure, mean arterial pressure, cerebral perfusion pressure and heart rate were studied during induction, tracheal intubation and skin incision in 23 patients scheduled for elective craniotomy. Premedication consisted of midazolam 0.1 mg/kg intramuscularly and metoprolol 1 mg/kg orally. Measurements were made or derived at time zero and 0.5, 1, 1.5, 2 and 3 minutes after an induction dose of propofol 1.5 mg/kg. ⋯ Heart rate did not change. Propofol combined with moderate dose of fentanyl, obtunded the usual cerebrospinal fluid and arterial pressure responses to intubation and other noxious stimuli. Thus propofol seems to be a suitable intravenous anaesthetic agent for induction and maintenance in neuroanaesthesia.
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Anesthesia and analgesia · Feb 1988
Randomized Controlled Trial Comparative Study Clinical TrialLaser-induced pain for evaluation of local analgesia: a comparison of topical application (EMLA) and local injection (lidocaine).
High-energy lasers are suitable for experimental pain stimulation because they selectively activate the polymodal nociceptors. Argon laser light penetrates deep into the skin and makes this laser type preferable for simulating pain arising from surgical skin incisions. Short argon laser pulses were applied to the skin and three parameters were quantified before and during analgesia; sensory threshold, pain threshold, and the pain-related cortical response (latency and amplitude). ⋯ During the next 30 minutes after removal of the cream, the thresholds increased further. The increase in analgetic effect after removal of the cream was studied using different times (15, 30, 60, 80, 100, and 120 minutes) for topical EMLA cream application. Total sensory block was reached 20 minutes after removal of application for 80 minutes or immediately after removal of the cream after it was applied for 100 or 120 minutes.(ABSTRACT TRUNCATED AT 250 WORDS)