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 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
Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical TrialTreatment of post-thoracotomy pain with intermittent instillations of intrapleural bupivacaine.
The effect of intrapleural bupivacaine in the treatment of post-thoracotomy pain was evaluated. Bupivacaine, 0.5% 20 ml, with adrenaline (5 micrograms/ml) was given through an indwelling intrapleural catheter, at 4-h intervals four times daily for 2 days. No pleural suction was applied during and 10 min after each injection. ⋯ The VAS and PQ scores 30 min after bupivacaine instillations diminished to an extent similar to that after oxycodone treatment. The need for analgesics during the day of operation was less in the bupivacaine group than in the control group (P less than 0.001). The number of oxycodone supplementation doses during 48 h postoperatively was, however, not smaller in the bupivacaine group than in the control group.
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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.