Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 1989
Randomized Controlled Trial Clinical TrialPropofol as an induction agent in children: pain on injection and pharmacokinetics.
The efficacy of lignocaine (1%) mixed with propofol in reducing pain on injection with propofol was studied in 40 children undergoing elective surgery in a double-blind, randomized comparison with glucose (5%). The pharmacokinetics of propofol in a single dose of 2.5 mg/kg was also studied in eight children participating in the same study. ⋯ The first-stage elimination half-life (t1/2 beta) of propofol in children was shorter (mean 9.3 +/- 3.8 (s.d.) min) than the values found in adults. This pharmacokinetic alteration may have clinical significance following repeated administration or continuous infusion of propofol.
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Acta Anaesthesiol Scand · Feb 1989
Randomized Controlled Trial Comparative Study Clinical TrialResidual curarization in the recovery room: atracurium versus gallamine.
Residual curarization in the recovery room was evaluated in 19 patients randomly allocated to two groups with nine and ten patients in each group, respectively. In one group atracurium was used for relaxation, and gallamine was used in the other. Anaesthesia was achieved with thiopental, diazepam, fentanyl and nitrous oxide in oxygen. ⋯ All patients in the atracurium group had TOF ratios above 0.70, and all of them were able to lift their head for 5 s. All patients were fully awake when they were evaluated, and no patient had any sign of respiratory difficulty. We conclude that residual curarization in the recovery room remains a problem and that this problem seems to be reduced when muscle relaxants of intermediate duration of action are used for relaxation during operation.
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Acta Anaesthesiol Scand · Feb 1989
Randomized Controlled Trial Comparative Study Clinical TrialEffects of epidural bupivacaine and epidural morphine on bowel function and pain after hysterectomy.
A comparison was made of the effects of continuous epidural analgesia with bupivacaine and intermittent epidural morphine on bowel function after abdominal hysterectomy. The duration of postoperative ileus was assessed as the time from the end of operation to the first postoperative passage of flatus and feces. Twenty-two patients were randomly allocated to two equal groups. ⋯ The time to first postoperative passage of feces was shorter (P less than 0.05) in the former than in the latter 57 +/- 44 h vs 92 +/- 22 h). The patients of the epidural bupivacaine group started intake of oral fluids earlier (P less than 0.01) and to a greater extent (P less than 0.05) than those in the epidural morphine group. It is concluded that the duration of postoperative ileus after hysterectomy is shorter when epidural bupivacaine is given for postoperative pain relief than when this is achieved by epidural morphine.
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Acta Anaesthesiol Scand · Feb 1989
Comparative StudyCardiotoxicity of ropivacaine--a new amide local anaesthetic agent.
Anaesthetically equipotent doses of lidocaine, bupivacaine and a new bupivacaine-like local anaesthetic agent, ropivacaine, were injected into the left anterior descending coronary artery of pentobarbital-anaesthetized pigs. The aim was to study the cardiotoxicity of ropivacaine in relation to the two other drugs. A random, crossover, dose response study design was used. ⋯ Comparable prolongation of the QRS-interval was recorded after 2 mg of bupivacaine, 4.5 mg of ropivacaine and 30 mg of lidocaine. Thus, the electrophysiological toxicity ratio was 15:6.7:1 (B:R:L). Provided local anaesthetic potency data can be extrapolated from the isolated nerve preparation to regional anaesthesia in humans, ropivacaine appears to provide a greater margin of safety than bupivacaine, if inadvertently injected into the venous circulation.