European journal of anaesthesiology
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Although the administration of alfentanil is routine in neurosurgical anaesthesia, the effects of the drug on cerebrospinal fluid pressure (CSFP) or intracranial pressure (ICP) have been a subject of controversy in the past. Therefore the effects of alfentanil (3 micrograms kg-1) on mean lumbar cerebrospinal fluid pressure (CSFP), heart rate (HR), mean arterial pressure (MAP), central venous pressure (CVP) and end-tidal carbon dioxide (ETCO2) in human volunteers without cerebral disease is reported here. The CSFP increased from 9 mmHg (P < 0.05) after intravenous (i.v.) injection of alfentanil, to 12 mmHg whereas MAP, CVP, HR and ETCO2 remained stable throughout the investigative period. The results from this study suggest that alfentanil, even when administered in low doses, leads to a relatively small but statistically significant increase in CSFP in humans with uncompromised intracranial compliance.
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Randomized Controlled Trial Clinical Trial
Intraarticular morphine administration provides pain relief after knee arthroscopy.
This present study investigated the effects of intraarticular morphine administration in 1 mg and 5 mg doses on post-operative pain relief and analgesic requirements for patients undergoing arthroscopic procedures. At the end of the operation patients were randomly allocated in a double-blinded fashion into three groups. The control group (Group 1) received normal saline 20 mL intraarticularly. ⋯ Supplementary analgesic requirement and possible complications were also followed. The intensity of pain and analgesic requirement were reduced more in the morphine 5 mg group than in the control group. It is concluded, that the administration of intraarticular morphine 5 mg provides long-lasting and effective analgesia after knee arthroscopy.
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Randomized Controlled Trial Clinical Trial
Cardiovascular and metabolic responses to clonidine and midazolam premedication.
In this double-blind placebo controlled study the preoperative cardiovascular and metabolic effects of intramuscular (i.m.) clonidine and midazolam are assessed. Forty-five ASA Grade I patients (n = 15 per group) undergoing plastic surgical procedures were randomly allocated to receive either placebo, clonidine 4 micrograms kg-1 or midazolam 70 micrograms kg-1. Drugs were administered into the deltoid muscle approximately 90 min prior to the scheduled induction of anaesthesia. ⋯ The decrease in VO2 and EE was maximally 11-14% on average from the base-lines after clonidine and midazolam. These effects were of longer duration after clonidine and lasted until the end of the 90 min study period. In conclusion, both clonidine and midazolam are effective as a means of decreasing pre-operative VO2 and EE.
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Reports about post-operative infections associated with the use of propofol prompted us to investigate the in-use contamination of lipid-formulated intravenous (i.v.) anaesthetics used for general anaesthesia or for sedation of intensive care patients in this department. The level and incidence of extrinsic contamination of propofol ('Diprivan') and of another intravenous anaesthetic, etomidate, formulated in lipid solution ('Etomidat-lipuro') was found to be low during two study periods. However, the need to observe strict aseptic precautions in handling these intravenous drugs must be emphasized.