European journal of anaesthesiology
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison between total intravenous anaesthesia using a propofol/alfentanil mixture and an inhalational technique for laparoscopic gynaecological sterilization.
Thirty patients undergoing laparoscopic gynaecological sterilization, as day-cases, were randomly allocated to receive either total intravenous anaesthesia (TIVA) with a propofol and alfentanil mixture or a standard inhalational technique. Immediate recovery, as measured by times to awakening, co-operation and orientation, and psychomotor recovery, as measured by 'P' deletion studies, were not significantly different between the two groups. ⋯ There were no differences between the two groups with respect to suitability for discharge home and no incidences of awareness. We conclude that TIVA with a propofol and alfentanil mixture provides satisfactory anaesthesia for gynaecological sterilization, with good recovery characteristics and a low incidence of post-operative nausea and vomiting.
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Randomized Controlled Trial Comparative Study Clinical Trial
Post-operative intravenous continuous analgesia: comparison of buprenorphine, fentanyl and nalbuphine.
Continuous intravenous infusions of fentanyl, buprenorphine or nalbuphine were investigated to provide pain relief for patients after major abdominal surgery. Buprenorphine (n = 23) was given as a loading dose of 5 micrograms kg-1 and infused at 0.8 micrograms kg-1 h-1. Fentanyl (n = 20) was given as a loading dose of 2 micrograms kg-1 and infused at 0.7 micrograms kg-1 h-1. ⋯ The infusion rate was increased when analgesia was inadequate, and decreased if respiratory depression occurred. Mean doses were respectively 0.74 +/- 0.15 microgram kg-1 h-1 buprenorphine, 0.68 +/- 0.18 microgram kg-1 h-1 fentanyl, 83 +/- 21 micrograms kg-1 h-1 nalbuphine. Titration of continuous intravenous infusion of buprenorphine and fentanyl provided better analgesia than nalbuphine with smaller doses than those reported in similar studies allowing spontaneous breathing.
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Randomized Controlled Trial Clinical Trial
Effect of nitrous oxide on middle ear pressure: a comparison between inhalational anaesthesia with nitrous oxide and TIVA.
We have investigated the effect of nitrous oxide on the middle ear pressure, comparing inhalational anaesthesia with nitrous oxide and halothane and total intravenous anaesthesia with propofol-alfentanil. Fifty patients with normal healthy ears were divided into two groups. In one group (n = 25), anaesthesia was induced with thiopentone 6 mg kg-1, and maintained with halothane 1% and nitrous oxide 66% in oxygen. ⋯ A progressive rise was observed (P < 0.05) in the first group, whereas values were within the normal limits clinically and there was no statistically significant change in those receiving total intravenous anaesthesia during the intra-anaesthetic period. The time to reach peak pressure with inhalational anaesthesia was 60 min (181.5 mmH2O) and to return to normal was 30 min (49.5 mmH2O) after cessation of nitrous oxide administration. The incidence of nausea and vomiting was less in the patients not receiving nitrous oxide.
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Randomized Controlled Trial Comparative Study Clinical Trial
Changes in respiratory pattern during induction of anaesthesia with sevoflurane: comparison of nasal and the oral breathing.
In order to test the hypothesis that the effects on ventilation of nasal inhalation of sevoflurane during induction of anaesthesia differ from those of oral inhalation, 20 patients underwent inhalation induction of anaesthesia with sevoflurane 5% either through the nasal route or the oral route. In 10 patients who breathed through the nose (N-group), there was an immediate decrease in tidal volume with no change in respiratory duration whereas no similar change was observed in the 10 patients who breathed through the mouth (O-group). The time from the start of sevoflurane inhalation to the onset of sleep was significantly shorter in the O-group compared with the N-group [86.2 +/- 4.4 (mean +/- SE) vs. 115.0 +/- 8.4 sec, P < 0.01].
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Randomized Controlled Trial Clinical Trial
Attenuation of the oculocardiac reflex after topically applied lignocaine during surgery for strabismus in children.
The effect of topical lignocaine applied to the eye muscles, on the incidence of the oculocardiac reflex during squint surgery of the medial rectus was investigated in 56 healthy children aged between 3-14 years. Three groups were studied. ⋯ Severe bradycardiac rhythm disturbances, in particular cardiac stand-still, were not observed after lignocaine had been applied. Systemic side effects of lignocaine were not seen.