Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Feb 1982
Randomized Controlled Trial Clinical TrialInfluence of epidural morphine on postoperative pain, endocrine-metabolic, and renal responses to surgery. A controlled study.
In order to assess the analgesic properties of epidural low-dose morphine and its possible influence on the adrenocortical, hyperglycemic, renal, electrolyte and leukocyte responses to surgery and nitrogen excretion, a double-blind randomized study was undertaken in 14 otherwise healthy patients admitted for hysterectomy under halothane, N2O/o2 anesthesia. Before induction of anesthesia, an epidural catheter was introduced into the lumbar epidural space. After induction of anesthesia, either morphine 4 mg in 10 ml saline or 10 ml saline was injected into the epidural space, according to the allocation. ⋯ Plasma concentration of cortisol and glucose, plasma-and urine electrolytes, 24-h creatinine and free-water clearances, diuresis, fluid balance, leukocyte count and nitrogen excretion differed insignificantly between groups. In conclusion, epidural low-dose morphine is a superior alternative to conventional postoperative pain treatment because of greater and longer lasting pain relief, without apparent side-effects. The measured endocrine-metabolic and renal response did not differ between groups, indicating that low-dose epidural morphine does not inhibit afferent neurogenic stimuli from the site of surgical trauma.
-
Acta Anaesthesiol Scand · Feb 1982
Cardiocirculatory effects of prolonged administration of isoflurane in normocarbic human volunteers.
Effects of the prolonged administration of isoflurane on haemodynamics were studied in 17 healthy volunteers under normocarbic conditions. The anaesthetic was administered for 90 min at a constant alveolar concentration. Cardiac index was unchanged in the presence of decrease stroke volume index and increased heart rate. ⋯ Left ventricular work decreased. The left ventricular ejection time index increased marginally but significantly. Isoflurane caused no change in the pump performance of the heart but depressed the muscle performance.
-
Acta Anaesthesiol Scand · Feb 1982
Droperidol (Dehydrobenzperidol): postoperative anti-emetic effect when given intravenously to gynaecological patients.
In a double-blind investigation, comprising 300 gynaecological patients, the prophylactic use of droperidol i.v. at the start of the anaesthesia produced significant reduction in the frequency of nausea and vomiting postoperatively in the first 24 h from 34.4% to 10.3% (P=0.0001). There was no significant difference between the effect of droperidol 2.5 mg and 5 mg (P=0.45). Increased postoperative sedation was the only side-effect of any importance observed; however, this did not result in any increased period of observation in the recovery room, and the majority of patients considered it advantageous. Droperidol is recommended as a prophylactic anti-emetic for selected groups of patients, given as 2.5 mg i.v. at the start of the anaesthesia.
-
Acta Anaesthesiol Scand · Feb 1982
Routine induction of anaesthesia with thiopental and suxamethonium: apnoea without ventilation?
Changes in Paco2 and Paco2 during the induction of anaesthesia with thiopental suxamethonium, and intubation were investigated in 20 patients who received preoxygenation for 2 min, but no ventilation before intubation. Both in fit patients below the age of 60 years (Group I) and in patients above the age-several suffering from cardiopulmonary disease - (group II), Pao2 increased to about 40 kPa during preoxygenation and remained at the level during apnoea. ⋯ No complications were seen, and it is concluded that the apnoea involved in the "crash induction" technique is sage. Pulmonary aspiration of acid gastric fluid may also occur in fasting patients, and it is suggested that even in elective cases ventilation might advantageously be replaced by preoxygenation when anaesthesia is induced with thiopental and suxamethonium.