Anesthesia and analgesia
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Anesthesia and analgesia · Feb 1984
Randomized Controlled Trial Comparative Study Clinical TrialVasoconstrictors in spinal anesthesia with tetracaine--a comparison of epinephrine and phenylephrine.
A randomized double-blind study was conducted in 50 orthopedic patients to determine the effect of epinephrine and phenylephrine on the anesthetic properties of intrathecally administered tetracaine. Two doses of each vasoconstrictor agent were studied: 0.2 mg of epinephrine, 0.3 mg of epinephrine, 1 mg of phenylephrine, and 2 mg of phenylephrine. The results show that both vasoconstrictor agents in the doses used significantly prolong duration of sensory anesthesia and motor blockade produced by the subarachnoid administration of tetracaine. At equipotent doses no differences existed between the ability of epinephrine and phenylephrine to prolong the duration of spinal anesthesia produced by tetracaine.
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Anesthesia and analgesia · Feb 1984
Fentanyl- and sufentanil-oxygen-pancuronium anesthesia for cardiac surgery in infants.
The safety and efficacy of fentanyl-oxygen (50 and 75 micrograms/kg) and sufentanil-oxygen (5 and 10 micrograms/kg) were studied in 40 infants undergoing repair of complex heart defects. When fentanyl or sufentanil was given simultaneously with pancuronium, induction of anesthesia was rapid and smooth with only mild and clinically insignificant hemodynamic changes. Hemodynamic responses to tracheal intubation were completely blocked, whereas hemodynamic responses to surgical incision and sternotomy were partially and variably blocked. ⋯ Transcutaneous oxygen tensions increased with induction, intubation, and surgical stimulation with both fentanyl and sufentanil, even in cyanotic patients with right to left shunts. Fentanyl- and sufentanil-oxygen-pancuronium anesthesia were both safe and effective for cardiac surgery in infants. This study raises the question of possible beneficial effects of high dose fentanyl and sufentanil in blunting stress responses in the pulmonary circulation, a critical aspect of anesthesia and intensive care in the infant and neonate.