Anesthesia and analgesia
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Anesthesia and analgesia · Nov 1994
Randomized Controlled Trial Comparative Study Clinical TrialCost comparison: a desflurane- versus a propofol-based general anesthetic technique.
The purpose of this study was to compare the cost of a desflurane-based with a propofol-based general anesthetic technique. Fifty ambulatory orthopedic surgery patients were randomly assigned to one of two groups. Premedication and induction of anesthesia were standardized in both groups. ⋯ In conclusion, maintenance general anesthesia with our desflurane technique was considerably less expensive than with our propofol technique. PACU stay was not increased using desflurane as opposed to propofol in our study. Desflurane offers a cost effective alternative to propofol for ambulatory general anesthesia.
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Anesthesia and analgesia · Nov 1994
Comparative StudyEvaluation of the Bullard laryngoscope using the new intubating stylet: comparison with conventional laryngoscopy.
The Bullard laryngoscope (BL) is a new device for managing the difficult airway. Previous publications on the BL are primarily descriptive, and fail to use internal controls (i.e., determine the best intubating mechanism) or external controls (i.e., compare the BL to a known standard such as conventional laryngoscopy). ⋯ Our results also suggest that the time to successful intubation with the BL using the intubating stylet was not affected by the conventional laryngoscopic grade; it was just as easy (and difficult) to intubate a conventional Grade I laryngoscopic view patient (full glottic view) as it was to intubate a conventional Grade III laryngoscopic view patient (visualization of just the epiglottis) with the BL. There were two failed intubations with the BL (3%) due to an inability to trap the epiglottis.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Nov 1994
Effects of a perfluorocarbon emulsion on regional cerebral blood flow and metabolism after fluid resuscitation from hemorrhage in conscious rats.
Regional cerebral blood flow and metabolism were investigated after addition of a small volume of perfluorocarbon (PFC) emulsion to the resuscitation fluid after hemorrhage. Severe volume-controlled hemorrhage (40 mL/kg body weight (bw) withdrawn over 30 min followed by hypovolemia of 30 min duration) was induced in conscious rats. While breathing 100% oxygen, the intravascular volume was repleted by the infusion of either 6% hydroxyethyl starch (mean mol wt 200,000/0.5; HES) or 6% hydroxyethyl starch plus perflubron (90% wt/vol emulsion of perfluoroctylbromide, 3 mL/kg bw; HES-PFOB). ⋯ The HES-PFOB group showed LCBF values that were higher in the different brain structures than those of the HES group (mean +30%). A close correlation was found between LCGU and LCBF of the 34 brain structures in both groups (HES: r = 0.96, P < 0.01; HES-PFOB: r = 0.98, P < 0.01), whereas the LCBF-to-LCGU ratio was reset from 2.2 mL/mumol in the HES group to 3.4 mL/mumol in the HES-PFOB group (P < 0.05). The higher blood flows in the HES-PFOB group were sufficient to restore cerebral oxygen delivery to normal levels at a reduced arterial oxygen content.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Nov 1994
Effect of ketamine on heterogeneity of cerebral microregional venous O2 saturation in the rat.
Heterogeneity of microregional O2 supply and consumption balance exists in the brain. Previous studies have shown that anesthetics such as pentobarbital and isoflurane, decrease the heterogeneity of O2 saturation in the small veins of the brain. This study was performed to determine whether ketamine, an anesthetic, would alter this heterogeneity. ⋯ The average regional O2 supply-to-consumption ratios were similar in the three brain regions in both of the groups. However, there was heterogeneity of the O2 saturation in small veins in all the brain regions that we studied. The coefficient of variation [CV = (SD/mean X 100] of venous O2 saturation of the ketamine group in the anterior cortex (19.8 +/- 7.2), in the posterior cortex (18.8 +/- 9.4), and in the pons (16.7 +/- 6.5) was not significantly different from that in the conscious animals (22.8 +/- 6.4, 23.1 +/- 5.3, and 15.7 +/- 6.4, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Nov 1994
Randomized Controlled Trial Multicenter Study Clinical TrialOndansetron prevents postoperative nausea and vomiting in women outpatients.
Three doses of intravenous (i.v.) ondansetron, 1 mg, 4 mg, and 8 mg, were compared to placebo for their antiemetic effect and safety. The drugs or placebo were administered in a double-blind manner, prophylactically to 589 women undergoing elective outpatient surgical procedures under nitrous oxide opioid-based general endotracheal anesthesia. In the postanesthesia care unit, the number of emetic episodes, periodic assessments of nausea severity using an 11-point scale (0 = no nausea; 10 = worst nausea), vital signs, and adverse events were collected by an independent observer for 2 h. ⋯ Heart rate, blood pressure, respiratory rate, and laboratory safety variables were not different among the groups. Ondansetron did not prolong awakening time. This study indicates that ondansetron is a safe and effective prophylactic antiemetic for women who have outpatient surgery under nitrous oxide opioid-based general anesthesia.