European journal of anaesthesiology
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Randomized Controlled Trial Multicenter Study
Regular tramadol use does not affect the propofol dose requirement for induction of anaesthesia.
An increased risk of awareness during general anaesthesia in patients receiving tramadol has been reported. We studied whether tramadol affects the amount of propofol required for induction of anaesthesia. ⋯ Tramadol did not affect the dose of propofol required to achieve loss of consciousness or burst suppression pattern in electroencephalogram during induction of general anaesthesia. However, there was a ninefold inter-individual variation in propofol dose requirement for loss of consciousness and a fivefold variation for reaching burst suppression. Due to extensive inter-individual variability, monitoring the level of hypnosis during general anaesthesia using propofol may enhance the correct dosage.
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In most studies of cardiac output changes after spinal anaesthesia, the time-resolution is limited. The aim of this study was to demonstrate cardiac output changes with high time-resolution during onset of spinal anaesthesia in elderly patients. ⋯ Using this high time-resolution method, we detected biphasic changes in cardiac output during onset of spinal anaesthesia. Initially, cardiac output increased. Subsequently, it was significantly reduced from baseline, although this decrease was of minor clinical importance.
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Randomized Controlled Trial
Reduction of pain on injection of propofol: combination of pretreatment of remifentanil and premixture of lidocaine with propofol.
There is a high incidence of pain following intravenous injection of propofol, and many studies have been conducted to find a way of reducing this. The administration of lidocaine and, recently, remifentanil has also been used for this purpose, but it is only partially effective. Thus, the purpose of this study was to investigate the analgesic effect of a combination of pretreatment with remifentanil and premixture of lidocaine with propofol and to compare either treatment alone during propofol injection in dorsal hand-veins. ⋯ The combination of pretreatment of remifentanil and premixture of lidocaine with propofol was more effective in reducing the incidence of pain on injection of propofol than either treatment alone.