Anaesthesia and intensive care
-
Anaesth Intensive Care · Feb 2004
Randomized Controlled Trial Comparative Study Clinical TrialThe addition of sufentanil, tramadol or clonidine to lignocaine for intravenous regional anaesthesia.
This study was designed to evaluate the effect of sufentanil, tramadol or clonidine added to lignocaine for intravenous regional anaesthesia. We investigated the onset and duration of sensory and motor block, the quality of the anaesthesia, intraoperative and postoperative haemodynamics, intraoperative and postoperative pain and sedation. Sixty patients undergoing ambulatory hand surgery received intravenous regional anaesthesia using 35 ml of 0.5% lignocaine and either 5 ml saline (Group L, n = 15); sufentanil 25 micrograms (Group LS, n = 15); tramadol 100 mg (Group LT, n = 15) or clonidine 1 microgram.kg-1 (Group LC, n = 15). ⋯ Compared to the other groups, in Group L the onset of sensory block was longer, the time to initial tourniquet pain was shorter and the intraoperative tourniquet pain scores and use of the opioid were higher (P < 0.05). The quality of anaesthesia in Groups LS, LT and LC was better than in Group L (P < 0.05). In conclusion, the addition of sulfentanil, tramadol or clonidine to lignocaine shortened the onset of the sensory block, delayed the onset time of the tourniquet pain and reduced the intraoperative consumption of opioid, but did not affect postoperative pain.
-
Anaesth Intensive Care · Feb 2004
Randomized Controlled Trial Comparative Study Clinical TrialComparison of a radiant patient warming device with forced air warming during laparoscopic cholecystectomy.
The importance of maintaining a patient's core body temperature during anaesthesia to reduce the incidence of postoperative complications has been well documented. The standard practice of this institution is the use of a forced air device for intraoperative warming. The purpose of this study was to compare this standard with an alternative warming device using a radiant heat source which only heated the face. ⋯ The study failed to show any statistical or clinical difference between the two patient groups in terms of mean core temperature both intraoperatively (P = 0.42) and in the recovery period (P = 0.54). Mean start to end core temperature differences were marginally lower in the radiant group (0.08 degree C) but not statistically or clinically significantly different. Given some of the drawbacks with forced air systems, such as the expense of the single use blanket, this new radiant warming device offers an alternative method of active warming with advantages in terms of cost and possible application to a wide variety of surgical procedures.
-
Anaesth Intensive Care · Feb 2004
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialRandomized evaluation of the single-use SoftSeal and the re-useable LMA Classic laryngeal mask.
A number of laryngeal masks are available, including both re-usable and single-use masks. Single-use laryngeal masks may decrease the risk of transmitting prion infections. We performed a single-blind randomized trial in 200 spontaneously breathing female patients under general anaesthesia with nitrous oxide, to compare a new single-use laryngeal mask, the SoftSeal (Portex Ltd, U. ⋯ An estimation of cost per patient use was greater for the re-usable mask. We conclude that the SoftSeal single-use laryngeal mask and the LMA Classic re-usable laryngeal mask airway are of similar clinical utility in terms of successful insertion and airway maintenance. The re-usable laryngeal mask was easier to insert and associated with less postoperative sore throat, but costs were higher.
-
Anaesth Intensive Care · Feb 2004
Randomized Controlled Trial Comparative Study Clinical TrialBispectral index during modified rapid sequence induction using thiopentone or propofol and rocuronium.
This randomized controlled trial compared Bispectral Index (BIS) values in 40 patients after a modified rapid sequence induction using thiopentone 4 mg/kg or propofol 2 mg/kg with rocuronium 0.6 mg/kg as muscle relaxant. Endotracheal intubation was performed at 60 seconds from induction of anaesthesia and BIS values were recorded for three minutes after induction. ⋯ No explicit recall of intubation was detected clinically with either induction agent. The BIS scores we have measured suggest that thiopentone 4 mg/kg is more likely to be associated with lighter planes of anaesthesia and consequent risk of awareness than propofol 2 mg/kg, if intubation is delayed or prolonged.