The Journal of international medical research
-
Randomized Controlled Trial
The combination of low-dose levobupivacaine and fentanyl for spinal anaesthesia in ambulatory inguinal herniorrhaphy.
This study investigated whether the addition of 25 microg intrathecal fentanyl to levobupivacaine spinal anaesthesia for outpatient inguinal herniorrhaphy allows a sub-anaesthetic levobupivacaine dose to be used. Forty patients were assigned to receive 5 mg levobupivacaine 0.5% mixed with 25 microg fentanyl (group LF) or 7.5 mg levobupivacaine 0.5% (group L). ⋯ These results indicate that, for outpatient inguinal herniorrhaphy, intrathecal fentanyl combined with low-dose levobupivacaine provides good quality spinal anaesthesia and minimizes the need for intra-operative analgesia. This protocol is well suited for the outpatient setting because it features rapid recovery of full motor power, sensory function and bladder function.
-
The effects of propofol on glucose metabolism in different cerebral regions were observed, using positron emission tomography (PET) technology, to determine a possible cerebral target region. Seven healthy volunteers were injected with (18)F-fluorodeoxyglucose developing agent for PET scanning whilst awake (control group T1), during sedation (induced by 1.5 microg/ml propofol administered by target controlled injection [TCI], group T2) and when unconsciousness (induced by 2.5 microg/ml propofol administered by TCI, group T3). Whole brain glucose metabolism was reduced during propofol anaesthesia; this was initially observed in the cortical areas at the lower dose of propofol (group T2) but extended to the subcortical regions, especially the thalamus and hippocampus, at the higher dose (group T3). This suggests that these regions of the brain might be important targets that are susceptible to propofol.
-
Randomized Controlled Trial Comparative Study
Comparison of three warming devices for the prevention of core hypothermia and post-anaesthesia shivering.
The efficacy of forced air warming with a surgical access blanket in preventing a decrease in core temperature during anaesthesia and post-anaesthesia shivering (PAS) was compared with two widely used interventions comprising forced air warming combined with an upper body blanket, and a circulating water mattress, in a prospective, randomized double-blind study. A total of 90 patients undergoing total abdominal hysterectomy were studied, 30 in each group. ⋯ Core temperature fell in all three groups compared with the baseline, but forced air warming using a surgical access blanket was more effective than the other warming methods in ameliorating the temperature decrease. The surgical access blanket was also superior to the circulating water mattress in reducing PAS.
-
Randomized Controlled Trial
Tramadol as a local anaesthetic in tendon repair surgery of the hand.
This double-blind pilot study compared the local anaesthetic effects of tramadol plus adrenaline with lidocaine plus adrenaline during surgery to repair hand tendons. Twenty patients were randomly allocated to receive either 5% tramadol plus adrenaline (n = 10) or 2% lidocaine plus adrenaline (n = 10). Injection site pain and local skin reactions were recorded. ⋯ There was no difference in the quality of sensory blockade or the incidence of side effects between the two groups. Only patients treated with tramadol did not require additional post-operative analgesia. A combination of tramadol plus adrenaline provided a local anaesthetic effect similar to that of lidocaine plus adrenaline.
-
Randomized Controlled Trial
Combination of ultra-low dose bupivacaine and fentanyl for spinal anaesthesia in out-patient anorectal surgery.
This study investigated whether the addition of 25 microg fentanyl to an ultra-low (sub-anaesthetic) dose of intrathecal bupivacaine provides adequate anaesthesia for out-patient anorectal surgery, without increasing side-effects or delaying hospital discharge. Patients were randomly allocated to receive 2.5 mg 0.5% bupivacaine plus 25 microg fentanyl (group BF, n = 18) or 5 mg 0.5% bupivacaine alone (group B, n = 17). ⋯ Fewer patients requested analgesic medication in the early post-operative period in group BF than in group B. In conclusion, 25 microg intrathecal fentanyl added to ultra-low dose (2.5 mg) bupivacaine provided good-quality spinal anaesthesia and reduced post-operative analgesic requirement in patients undergoing ambulatory anorectal surgery.