Anesthesia and analgesia
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Anesthesia and analgesia · Dec 1994
Randomized Controlled Trial Comparative Study Clinical TrialPremedication with oral and transdermal clonidine provides safe and efficacious postoperative sympatholysis.
We studied 61 patients undergoing elective major non-cardiac surgery in a randomized, double-blind, placebo-control clinical trial to test the hypothesis that the addition of clonidine to a standardized general anesthetic could safely provide postoperative sympatholysis for patients with known or suspected coronary artery disease. Patients were allocated randomly to receive either placebo (n = 31) or clonidine (n = 30). The treatment group received premedication with a transdermal clonidine system (0.2 mg/d) the night prior to surgery, which was left in place for 72 h, and 0.3 mg oral clonidine 60-90 min before surgery. ⋯ There were no differences in the need for intravenous fluid therapy or antihypertensive therapy after surgery. The number of hours spent in an intensive care setting and the number of days spent in hospital were not different between the two groups. These results suggest that larger doses of clonidine should be investigated for their ability to decrease postoperative tachycardia and myocardial ischemia.
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Anesthesia and analgesia · Dec 1994
Randomized Controlled Trial Comparative Study Clinical TrialA first-pass cost analysis of propofol versus barbiturates for children undergoing magnetic resonance imaging.
Intravenous (IV) propofol was compared with IV thiopental/pentobarbital as a sedative for children undergoing magnetic resonance imaging (MRI) of the brain or spine. Fifty-eight outpatients (aged 11 mo to 6 1/2 yr, ASA grade I and II) were enrolled in the study and randomized to two groups. After IV cannulation, Group I received IV propofol (1-2 mg/kg), followed immediately by a propofol infusion (75-100 micrograms.kg-1.min-1). ⋯ Cost analysis of anesthesia services revealed added drug costs ($1600.76 per year for the propofol group) but significant savings of postanesthesia care unit (PACU) nursing time ($5086.67 per year). Outcomes such as patient morbidity and technical quality of the MRI scans did not differ significantly between the two groups. In conclusion, analysis of the clinical data suggests that propofol may be more suitable than barbiturates for children undergoing outpatient procedures despite its higher price.
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Anesthesia and analgesia · Dec 1994
Randomized Controlled Trial Clinical TrialBalanced postoperative analgesia: effect of intravenous clonidine on blood gases and pharmacokinetics of intravenous fentanyl.
Agonist interactions in antinociceptive effects between clonidine and opioids can be used to reduce opioid requirements in surgical patients. However, clonidine can cause marked sedation and associated respiratory dysfunction. Thus, the benefit of using clonidine to reduce opioid use on respiration is questionable. ⋯ Naloxone was required in six patients and oxygen in two patients of the fentanyl group (versus none in the group receiving clonidine). Dopamine, 10 micrograms.kg-1.min-1, was required in one patient of the clonidine-fentanyl group to correct hypotension. Mean arterial blood pressure, plasma clearance, and the elimination rate constant of fentanyl were lower in the clonidine-fentanyl group than in the fentanyl group.(ABSTRACT TRUNCATED AT 250 WORDS)
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Anesthesia and analgesia · Dec 1994
Comment Letter Randomized Controlled Trial Clinical TrialMivacurium ED95 recalculated.