Anesthesia and analgesia
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Anesthesia and analgesia · Oct 1994
Randomized Controlled Trial Clinical TrialPrevention of endotracheal tube-induced coughing during emergence from general anesthesia.
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Anesthesia and analgesia · Oct 1994
Randomized Controlled Trial Clinical TrialClonidine decreases the dose of thiamylal required to induce anesthesia in children.
Clonidine is a useful drug to give preoperatively because it produces anxiolysis, sedation, and hemodynamic stability, and reduces intravenous and volatile anesthetic requirements. Several premedicants, including midazolam and diazepam, have been shown to reduce the induction dose of intravenous anesthetics, such as thiopental, ketamine, or propofol. A randomized, double-blind controlled study was conducted to evaluate the effect of premedication with oral clonidine on thiamylal requirement for the induction of anesthesia and on associated hemodynamic changes in children. ⋯ The induction dose of thiamylal (mean +/- SD) was 5.4 +/- 0.9, 4.5 +/- 1.1, and 3.4 +/- 0.9 mg/kg for patients receiving placebo, clonidine 2 micrograms/kg, and clonidine 4 micrograms/kg, respectively (P < 0.05). Systolic BP decreased by 6.8%, 5.6%, and 6.6% and HR increased by 5.7%, 4.8%, and 4.1% after administration of thiamylal in the control (placebo) group and the clonidine 2 micrograms/kg and clonidine 4 micrograms/kg groups, respectively (P > 0.05). Premedication with oral clonidine reduced the dose of intravenous thiamylal required for the induction of anesthesia in children.
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Anesthesia and analgesia · Oct 1994
Comparative StudyIntracranial volume/pressure relationship during desflurane anesthesia in dogs: comparison with isoflurane and thiopental/halothane.
Desflurane-induced increase of intracranial pressure (ICP) does not appear to be completely explained by desflurane-induced changes in cerebral blood flow, cerebrospinal fluid (CSF) formation and reabsorption, or brain tissue water content. The present study was designed to determine whether desflurane alters intracranial volume/pressure relationships sufficiently to account for desflurane-induced increase of ICP. In 24 dogs, infusions of mock CSF were used to determine the CSF pressure increase due to increase of CSF volume, and the capacity of CSF pressure to return to baseline after a CSF pressure increase (CSF pressure normalization). ⋯ However, desflurane and isoflurane had no consistent effect on the other measures of CSF pressure increase caused by increase of CSF volume. Isoflurane also decreased the capacity for CSF pressure normalization at normal CSF pressure as indicated by decreased S1 and increased delta Ps. It is concluded that, under conditions of normal ICP, desflurane may decrease Ce, favoring an increase of ICP.
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Anesthesia and analgesia · Oct 1994
Comparative StudyProlonged analgesia and decreased toxicity with liposomal morphine in a mouse model.
Inadequate control of postoperative pain remains a major clinical problem. A reliable method of providing long-lasting postoperative analgesia with a single dose would be very useful. We synthesized a liposomal morphine formulation and compared it to free morphine with regard to duration of analgesia in the mouse. ⋯ In vitro experiments showed a slow release rate of morphine from the liposome depot. Prolonged analgesia and decreased systemic toxicity for liposomal morphine are explained by sustained release of morphine from the liposomal depot. These results suggest that liposomal narcotic formulations may provide prolonged analgesia with single-dose administration.