European journal of anaesthesiology
-
Randomized Controlled Trial Comparative Study Clinical Trial
Dreaming and anaesthesia: total i.v. anaesthesia with propofol versus balanced volatile anaesthesia with enflurane.
Sixty consecutive ASA Grades I and II patients scheduled for elective ear, nose and throat surgery were randomly assigned to receive either total i.v. anaesthesia with propofol ('propofol group') or 'balanced technique' with thiopentone induction followed by N2O and enflurane. Patients were asked whether they had experienced dreams immediately after extubation when verbal communication was established, in the recovery room and in the ward on the evening of the day of surgery. ⋯ In the recovery room and in the ward only three patients of the propofol group (10%) and one patient in the enflurane group (3%) remembered that they had been dreaming (NS). To avoid underestimating the frequency of peri-operative dreaming, post-operative interviews should take place as soon as possible after conversing is possible.
-
Randomized Controlled Trial Clinical Trial
Effect of pre-operative metoprolol on cardiovascular and catecholamine response and bleeding during hysterectomy.
The effect of a pre-operative dose of metoprolol on the catecholamine and cardiovascular responses to tracheal intubation and surgery, cardiac complications and intra-operative blood loss, were studied in patients undergoing elective hysterectomy during general anaesthesia. The study was double-blind and placebo controlled. The patients received metoprolol 100 mg or placebo orally 1-25 h before anaesthesia. ⋯ The incidence of arrhythmias was less after metoprolol. The mean operative blood loss was greater in the placebo group (486 +/- 170 ml (SEM) compared to 231 +/- 43 ml (SEM) after metoprolol). We conclude that oral premedication with metoprolol attenuates the hypertensive response to tracheal intubation and reduces both arrhythmias and operative blood loss.
-
Eight currently used factory-new anaesthesia circle systems (Dräger Cicero, Dräger Sulla, Dräger AV1, Gambro Engström Elsa, Megamed 700A, Ohmeda Modulus II Plus, Siemens Ventilator 710 and Siemens Servo Ventilator 900 D with circle system) and a Megamed 077 which had been clinically used for 11 years were tested for gas leaks according to the Draft European Standard Anaesthetic Workstations and Their Modules. All measurements were performed using the Cicero ventilator developed by Dräger with its integrated test program for the detection of system leakage. ⋯ In the 'manual' position and with the soda-lime canister and the volumeter (or flow-sensor) included, the following leak rates were determined: Dräger Cicero, 5.0 ml min-1; Dräger Sulla, 22.8 ml min-1; Dräger AV1, 7.7 ml min-1; Gambro Engström Elsa, 33.4 ml min-1; Megamed 700A, 11.5 ml min-1; Ohmeda Modulus II Plus, less than 0.1 ml min-1; Siemens Ventilator 710, 0.3 ml min-1; Siemens Servo Ventilator 900D with circle system 985, 9.6 ml min-1; Megamed 077, 47.5 ml min-1. All anaesthesia breathing circle systems tested performed below the leakage limit of 100 ml min-1 proposed by the draft standard.
-
Randomized Controlled Trial Comparative Study Clinical Trial
A haemodynamic comparison of epidural versus intrathecal sufentanil to supplement general anaesthesia for abdominal aortic surgery.
The present study was designed to evaluate the influence of epidural sufentanil (ES) and intrathecal sufentanil (IS) on the peri-operative haemodynamic responses during abdominal aortic surgery. Twenty-four ASA Grade II patients without clinical symptoms of coronary artery disease received, randomly, epidural (n = 12) or intrathecal (n = 12) sufentanil combined with light general anaesthesia for elective bifemoral grafting for aorto-iliac occlusive disease. The IS group contained significantly more hypertensive patients than the ES group. ⋯ Revascularization produced significant differences in HR, SVR and CI in both groups in comparison with the pre-declamping period. Notable was the maintenance of systemic blood pressure following revascularization due to preservation of sympathetic activity. It was concluded that both epidural and intrathecal sufentanil produce comparable and stable haemodynamics in this category of patients.