European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
The effects of propofol on laryngeal reactivity and the haemodynamic response to laryngeal mask insertion.
The ease of the insertion of laryngeal mask and the haemodynamic response were assessed 2 min after induction of anaesthesia with either propofol 2.5 mg kg-1 or thiopentone 4.0 mg kg-1 in 38 ASA I premedicated patients. The inserting conditions scored as excellent, good, poor and unable to insert were significantly better with propofol than with thiopentone (P < 0.001). Insertion of the laryngeal mask was followed by a transient but significant increase in both systolic (P < 0.05) and diastolic (P < 0.01) arterial pressure in the thiopentone group; there was no comparable response in the propofol group. The heart rate varied little from baseline in both groups.
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Randomized Controlled Trial Clinical Trial
Effects of prostaglandin E1 on intra-operative central and peripheral temperatures during upper abdominal surgery.
Effects of prostaglandin E1 (PGE1) on temperatures during upper abdominal surgery under isoflurane anaesthesia were studied. Forty-five patients were randomly assigned to one of three groups (15 patients per group). One group received 0.05 micrograms kg-1 min-1 of PGE1, the second group received 0.1 microgram kg-1 min-1 of PGE1 just after the induction of anaesthesia, and the third group received no PGE1 during anaesthesia (control). ⋯ In the 0.1 microgram kg-1 min-1 group, maximum decrease of tympanic membrane temperature was significantly larger than that in the control group. Fingertip temperatures in the 0.05 micrograms kg-1 min-1 group during surgery were significantly higher than those in the control group. This result suggests that 0.05 micrograms kg-1 min-1 of PGE1 may be superior to 0.1 microgram kg-1 min-1 of PGE1 for maintaining central and peripheral temperatures during surgery and general anaesthesia.
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Multichannel laser Doppler flowmeters allow continuous, simultaneous measurement of perfusion in several organs. We measured microcirculatory blood flow in the kidney, liver, skin and skeletal muscle in 10 anaesthetized rats subjected to abdominal surgery and graded haemorrhage (withdrawal of 5% total blood volume every 10 min). Mean arterial blood pressure, heart rate and haemoglobin concentrations were also measured. ⋯ We conclude that laser Doppler flowmetry is useful for continuous measurement of microcirculatory blood flow in several organs simultaneously during haemorrhagic hypovolaemia. It showed that microcirculatory blood flow in skeletal muscle is particularly sensitive to lesser degrees of blood loss during anaesthesia. Hypovolaemia-induced slow wave flowmotion occurred only in skeletal muscle, which may be linked to fluid mobilization during haemorrhage.