Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1989
Randomized Controlled Trial Comparative Study Clinical TrialIntravenous administration of isosorbide dinitrate attenuates the pressor response to laryngoscopy and tracheal intubation.
In order to evaluate the effect of isosorbide dinitrate (ISDN), administered as a bolus intravenous injection, on the circulatory response to tracheal intubation, mean arterial pressure (MAP), and heart rate (HR) in response to laryngoscopy for 30 s followed by tracheal intubation were compared in patients not receiving ISDN (control) and receiving 40 micrograms/kg or 80 micrograms/kg of ISDN 45 s before starting laryngoscopy. Each group consisted of 10 patients undergoing elective surgery. ⋯ HR increased to a similar extent in the three groups. These results indicate that a bolus injection of ISDN (80 micrograms/kg) is a simple, practical and highly effective means of attenuating the hypertensive response to direct laryngoscopy and tracheal intubation.
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Acta Anaesthesiol Scand · Apr 1989
Train-of-four fade during onset of neuromuscular block with nondepolarising neuromuscular blocking agents.
Fade in the train-of-four (TOF) responses during onset of neuromuscular block was studied following administration of atracurium (225 or 450 micrograms/kg), vecuronium (40 or 80 micrograms/kg), pancuronium (60 or 120 micrograms/kg) and tubocurarine (450 micrograms/kg). TOF ratios were measured at approximate heights of T1 (first response in the TOF) of 75, 50 and 25%. ⋯ The greatest difference between relaxants was observed at T1 of 25%, vecuronium showing the least fade and pancuronium, atracurium and tubocurarine showing increasing fade, in that order. The difference between atracurium and tubocurarine or between vecuronium and pancuronium was not significant, but the degree of TOF fade was significantly greater with atracurium and tubocurarine in comparison to vecuronium or pancuronium.
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Acta Anaesthesiol Scand · Apr 1989
Randomized Controlled Trial Clinical TrialSpinal buprenorphine for postoperative analgesia after caesarean section.
Two doses of intrathecal buprenorphine for postoperative analgesia have been compared. Forty-five women undergoing elective caesarean section under spinal anaesthesia were randomly divided into three groups. ⋯ Patients receiving buprenorphine had a longer pain-free interval than the controls (P less than 0.01). Within the buprenorphine groups, patients receiving the higher dose had a longer effect (420 min s.d. 24) than those receiving the lower dose (173 min s.d. 31) (P less than 0.01) without any increase in side-effects.
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Acta Anaesthesiol Scand · Apr 1989
Randomized Controlled Trial Clinical TrialAttenuation of the pressor response to laryngoscopy and tracheal intubation with intravenous verapamil.
This study was undertaken in surgical patients in order to evaluate the effects of intravenous verapamil on the circulatory responses to laryngoscopy and tracheal intubation. Laryngoscopy for tracheal intubation was initiated 1 min after thiamylal 5 mg.kg-1 and succinylcholine 1.5 mg.kg-1 in the control group (n = 21). The verapamil group (n = 23) received intravenous verapamil 0.1 mg.kg-1 immediately after thiamylal-succinylcholine administration. ⋯ For hypertensive patients, MAP increases from baseline after intubation were 18 +/- 9% in the verapamil group, and 53 +/- 14% in the control group, respectively (P less than 0.001). Increases in HR response to laryngoscopy for intubation were comparable in both groups. We conclude that intravenous verapamil is effective in reducing pressor responses during endotracheal intubation, especially in hypertensive patients.