Anesthesia and analgesia
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Anesthesia and analgesia · Nov 1985
Randomized Controlled Trial Comparative Study Clinical TrialA double-blind comparison of multiple intramuscular doses of ciramadol, morphine, and placebo for the treatment of postoperative pain.
Ciramadol, an agonist-antagonist analgesic (in intramuscular doses of 30 and 60 mg) was compared with 10 mg of morphine and placebo in a double-blind, parallel study in 160 patients with postoperative pain. The patients were assigned randomly to one of the four treatment groups and could receive a dose of the medication every 3 hr as needed for 48 hr; a maximum of six doses was allowed in a 24-hr period. Formal efficacy assessments using standard pain intensity and pain relief scales were restricted to the initial dose period. ⋯ Sedation was slightly higher with the active therapies than with placebo. Changes in vital signs were minimal. It is concluded that 60 mg of ciramadol compares favorably with 10 mg of morphine as a postoperative analgesic.
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Anesthesia and analgesia · Nov 1985
Fentanyl pharmacokinetics and hemodynamic effects in preterm infants during ligation of patent ductus arteriosus.
A bolus of 30 micrograms X kg-1 fentanyl was given to nine preterm infants (gestational age 31.8 +/- 4.7 weeks, weight 1100 +/- 309 g) for induction of anesthesia for ligation of a patent ductus arteriosus. Thirty minutes after the injection, fentanyl plasma concentrations were between 7.7 and 13.6 ng X ml-1. Elimination half-life was 6-32 hr (mean +/- SD, 17.7 +/- 9.3). ⋯ There was a gradual increase in heart rate from 159 +/- 12 min-1 at the time of skin incision to 173 +/- 15 min-1 at the time of skin closure (P less than 0.05). Fentanyl plasma concentrations remained virtually unchanged between 30 min (10.6 +/- 1.9 ng X ml-1) and 120 min (9.6 +/- 1.6 ng X ml-1); whereas at the end of surgery most infants moved and breathed spontaneously. This phenomenon can be explained by redistribution of fentanyl from brain into pharmacodynamically inert tissues.
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Anesthesia and analgesia · Nov 1985
Continuous monitoring of arterial oxygen saturation with pulse oximetry during transfer to the recovery room.
The incidence of hypoxemia in the immediate postoperative period was determined using a pulse oximeter for continuous monitoring of arterial oxygen saturation (SaO2) in 95 ASA class I or II adult patients breathing room air during their transfer from the operating room to the recovery room. Hypoxemia was defined as 90% SaO2 (arterial oxygen partial pressure (PaO2) approximately equal to 58 mm Hg). Severe hypoxemia was defined as 85% SaO2 (PaO2 approximately equal to 50 mm Hg). ⋯ Postoperative hypoxemia did not correlate significantly with anesthetic agent, age, duration of anesthesia, or level of consciousness. There was a statistically significant correlation (P less than 0.05) between hypoxemia and obesity. All three patients with a history of mild asthma became severely hypoxemic even though none had perioperative evidence of obstructive disease, also a statistically significant (P less than 0.003) finding.