Articles: anesthetics.
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Anesthesia and analgesia · Jul 2000
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA comparison of remifentanil and fentanyl in patients undergoing surgery for intracranial mass lesions.
We compared the effects of remifentanil versus fentanyl during surgery for intracranial space-occupying lesions. Patients were randomly assigned to receive either remifentanil (0.5 microg. kg(-1). min(-1) IV during the induction of anesthesia reduced to 0.25 microg. kg(-1). min(-1) after endotracheal intubation; n = 49) or fentanyl (dose per usual practice of the anesthesiologist; n = 54). Anesthesia maintenance doses of isoflurane, nitrous oxide, and opioid were at the anesthesiologist's discretion for both groups. There were no differences between opioid groups for the frequency of responses (hemodynamic, movement, and tearing) to intubation, pinhead holder placement, skin incision, or closure of the surgical wound. Adverse event frequencies were similar between groups. Times to follow verbal commands (P < 0.001) and tracheal extubation (P = 0. 04) were more rapid for remifentanil. The percentage of patients with a normal recovery score (were alert or arousable to quiet voice, were oriented, were able to follow commands, had motor function unchanged from their preoperative evaluation, were not agitated, and had modified Aldrete Scores of 9-10) at 10 min after surgery was more for remifentanil (45% vs 18%; P = 0.005). By 20 min, no difference between groups existed (P = 0.27). Anesthesiologists used more isoflurane in the fentanyl group (4.22 vs 1.93 minimum alveolar anesthetic concentration hours). Neurosurgeons, blinded to treatment group, favored the use of remifentanil. Similar frequencies of light anesthesia responses and other adverse events suggest that intraoperative depths of anesthesia were similar in the two groups. Under these conditions, emergence was more rapid with remifentanil. This is consistent with the necessity for less isoflurane use in the remifentanil group and the intrinsic rapid clearance of this opioid. ⋯ Patients given remifentanil-based anesthesia for craniotomy had faster recovery times from anesthesia than did those given fentanyl-based anesthesia.
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Pediatric dentistry · Jul 2000
Randomized Controlled Trial Multicenter Study Clinical TrialA comparison between articaine HCl and lidocaine HCl in pediatric dental patients.
Three identical single-dose, randomized, double-blind, parallel-group, active-controlled multicenter studies were conducted to compare the safety and efficacy of articaine HCl (4% with epinephrine 1:100,000) to that of lidocaine HCl (2% with epinephrine 1:100,000) in patients aged 4 years to 79 years, with subgroup analysis on subjects 4 to < 13 years. ⋯ VAS scores indicate that articaine is an effective local anesthetic in children and that articaine is as effective as lidocaine when measured on this gross scale. Articaine 4% with epinephrine 1:100,000 is a safe and effective local anesthetic for use in pediatric dentistry. Time to onset and duration of anesthesia are appropriate for clinical use and are comparable to those observed for other commercially available local anesthetics.
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Minerva anestesiologica · Jul 2000
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialPropofol 1% and propofol 2% are equally effective and well tolerated during anaesthesia of patients undergoing elective craniotomy for neurosurgical procedures.
The 2% formulation of the intravenous anaesthetic agent, propofol (Diprivan), delivers half the amount of lipid compared with the original 1% formulation. This may provide an acceptable alternative for patients who have an impaired ability to metabolise lipids. ⋯ We conclude that propofol 2% is as effective and as well-tolerated as propofol 1% for anaesthesia and is an acceptable alternative to propofol 1% in patients undergoing elective craniotomy in neurosurgery. The lower lipid load suggests it may be of particular benefit to patients with disorders of lipid metabolism.
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British dental journal · Jun 2000
Multicenter StudyEnvironmental monitoring of nitrous oxide during dental anaesthesia.
The study was carried out to see if levels of nitrous oxide in dental theatres and community dental clinics were being controlled in accordance with the Control of Substances Hazardous to Health Regulations. ⋯ The results highlighted the need to provide adequate control measures such as anaesthetic gas scavenging, to reduce occupational exposure to dental staff in dental operating theatres and community dental clinics, therefore providing a safe working environment.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Postoperative pain management in patients undergoing major surgery after remifentanil vs. fentanyl anesthesia. Multicentre Investigator Group.
To determine if morphine sulphate was an effective transition analgesic in patients receiving a remifentanil-based anesthetic regimen. ⋯ Morphine sulphate regimens of 0.15 or 0.20 mg x kg(-1) administered 30 min before the end of surgery are equally effective transition regimens for inpatient procedures.