Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Clinical Trial
Low-dose sufentanil as a supplement to halothane/N2O anaesthesia in infants and children.
Sufentanil as a supplement to halothane/N2O anaesthesia was evaluated in 32 unpremedicated infants and children age 6 months to 9 yr undergoing elective orthopaedic surgery. Patients were randomly assigned in a double-blind manner to receive one of four intravenous supplements: placebo, sufentanil 0.5, 1.0 or 1.5 micrograms.kg-1. Systolic arterial pressure (SAP), heart rate (HR) and end-tidal halothane concentration were recorded before and after induction, supplement administration, tracheal intubation, incision and every 15 min during the procedure. ⋯ One patient in the sufentanil 1.0 micrograms.kg-1 group whose surgical time was less than 45 min exhibited respiratory depression in the PACU requiring narcotic reversal. In conclusion, sufentanil 0.5 micrograms.kg-1 improved immediate postoperative pain relief and is acceptable as a supplement during halothane anasethesia in infants and children. The associated side effects of larger doses of sufentanil (1.0 and 1.5 micrograms.kg-1) make their use as a supplement to halothane anaesthesia unacceptable.
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The use of dantrolene to reverse severe unexplained postanaesthetic muscle rigidity in a previously "healthy" 13-year-old male is described. Anaesthesia was induced with thiopentone. After intubation with pancuronium, the patient had an entirely uneventful nitrous oxide, oxygen and halothane anaesthetic. ⋯ The symptoms responded to IV dantrolene in a total dose of 2.0 mg.kg-1. Further testing failed to establish a definite diagnosis. Dantrolene could be a useful drug in treating such unexplained muscle rigidity.
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Randomized Controlled Trial Clinical Trial
The effect of preoperative oral droperidol on the incidence of postoperative emesis after paediatric strabismus surgery.
Most children vomit after strabismus surgery. Administration of intravenous droperidol to unpremedicated paediatric patients following induction but prior to eye manipulation markedly reduces the incidence of postoperative emesis. This study tested the hypothesis that even earlier administration of droperidol, orally as a component of an oral premedication, would further reduce the incidence of postoperative emesis in this group of patients. ⋯ One group received the standard oral premedication used for all outpatients at our institution (meperidine 1.5 mg.kg-1, diazepam 0.15 mg.kg-1, atropine 0.02 mg.kg-1). In the other two groups, droperidol in a dose of 50 or 75 micrograms.kg-1 was substituted for the diazepam. Droperidol-treated groups demonstrated a significantly lower incidence of vomiting prior to hospital discharge compared to the groups that received the standard oral premedication (standard--73 per cent, 50 micrograms.kg-1 droperidol--33 per cent, 75 micrograms.kg-1 droperidol--36 per cent) without prolonging hospital stay.
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Clinical Trial Controlled Clinical Trial
Epidural fentanyl plus bupivacaine 0.125 per cent for labour: analgesic effects.
Ninety-five healthy nulliparous women, ASA physical status I-II with an uncomplicated pregnancy and single fetus in vertex position were given lumbar epidural analgesia. Patients in Group A (n = 35) received bupivacaine 0.125 per cent with epinephrine 1:800.000; Groups B (n = 30) and C (n = 30) received the same agents as Group A but with the addition to the initial dose of 50 or 100 micrograms of fentanyl respectively. ⋯ Only the addition of 100 micrograms of fentanyl improved significantly the quality of analgesia (43.3 per cent of excellent scores vs 6.6 per cent in Group B and 5.7 per cent in Group A). Addition of fentanyl did not affect the duration of labour, the method of delivery and the neonatal neurobehaviour scores.