Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 1990
Randomized Controlled Trial Clinical TrialDoes ephedrine influence newborn neurobehavioural responses and spectral EEG when used to prevent maternal hypotension during caesarean section?
The recovery of 16 infants born by elective caesarean section with spinal anaesthesia, in which either ephedrine or fluid load was used to prevent maternal hypotension, were studied using Scanlon's neurobehavioural tests and a computerized EEG. Neurobehavioural testing showed no differences between the ephedrine and the non-ephedrine groups of infants at ages of 3 h, 1 day, 2 days and 4-5 days, whereas the spectral EEG showed significant differences between the two groups during the first 2 h after delivery, which had disappeared 24 h later. It is suggested that small doses of ephedrine given to the mother i.v. to prevent hypotension during spinal anaesthesia have short-lived effects on the neonate's central nervous system, which will be detected in the spectral EEG, but not in neurobehavioural tests.
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Acta Anaesthesiol Scand · Jan 1990
Clinical Trial Controlled Clinical TrialEffects of alfentanil on the responses to awake fiberoptic nasotracheal intubation.
Intubation conditions and pressor response were assessed in 30 healthy patients undergoing awake nasotracheal intubation. The patients were premedicated with peroral diazepam. All the patients were sedated with intravenous diazepam 0.1 mg/kg. ⋯ Alfentanil caused moderate respiratory depression but significantly improved conditions for fiberoscopy. In the control group, arterial pressures and heart rate increased significantly immediately after tracheal intubation. These responses were attenuated by alfentanil.
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Acta Anaesthesiol Scand · Jan 1990
Comparative StudyEffects of thoracic epidural anaesthesia on central haemodynamics compared to cardiac beta adrenoceptor blockade in conscious rats with acute myocardial infarction.
The study aimed to compare the effects of thoracic epidural anaesthesia (TEA) with those of the beta-adrenoceptor blocker, metoprolol, on central haemodynamics in conscious rats with acute myocardial infarction. During methohexital anaesthesia, appropriate vascular catheters were inserted, a thoracic epidural catheter was implanted and the left coronary artery was ligated. A recovery period of 1-2 h elapsed after termination of surgery and anaesthesia. ⋯ The reduction in CO, SV, HR and max dP/dt was of the same magnitude with TEA and metoprolol. TEA lowered MAP by 17%, while metoprolol did not change MAP. Metoprolol caused an increase in LVEDP from 20.8 +/- 1.8 to 27.5 +/- 2.7 mmHg (2.8 +/- 0.2 to 3.7 +/- 0.4 kPa) (P less than 0.01), while TEA induced a decrease in LVEDP from 24.2 +/- 1.4 to 17.8 +/- 1.6 mmHg (3.2 +/- 0.2 to 2.4 +/- 0.2 kPa) (P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · Jan 1990
Muscle relaxants change myocardial metabolism in patients with ischemic heart disease during high-dose fentanyl anesthesia.
Although not unanimously accepted, high-dose fentanyl anesthesia has been associated with hemodynamic stability and little derangement of myocardial oxygen balance. This apparent inconsistency inspired us to investigate the effects on cardiac function and myocardial metabolism of stepwise increasing doses of fentanyl, accumulating to 15, 30, and 50 micrograms.kg-1, with the least possible interference from other drugs. Subjects were unpremedicated patients with ischemic cardiac disease scheduled for coronary artery bypass grafting or major vascular surgery. ⋯ In this group HR, RPP, CSF and MVO2 all increased at the lowest dose of fentanyl and HR additionally also at 30 micrograms.kg-1. The cardiac index was higher in the pancuronium group at the lowest and middle dose steps of fentanyl. Lactate uptake decreased with higher doses of fentanyl and relative myocardial lactate extraction declined.(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · Jan 1990
Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical TrialSublingual buprenorphine as postoperative analgesic: a double-blind comparison with pethidine.
Buprenorphine and pethidine as postoperative analgesics were compared in 96 women having gynaecological operations by lower laparotomy. A fixed dose of the respective drug was given in a double-blind and double-dummy manner, initially intramuscularly and thereafter by sublingual buprenorphine (0.4 mg) or intramuscular pethidine (75 mg) at the request of the patient during the first 24 h postoperatively. ⋯ There were no significant differences between the groups regarding respiratory depression and nausea. It appears that sublingual buprenorphine is as effective and safe as intramuscular pethidine in the postoperative period.