Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 1990
Randomized Controlled Trial Comparative Study Clinical TrialRandomized comparison of recovery after propofol-nitrous oxide versus thiopentone-isoflurane-nitrous oxide anaesthesia in patients undergoing ambulatory surgery.
A randomized, prospective study was performed to compare recovery characteristics in 41 ASA physical status I-II patients scheduled for ambulatory surgery with either propofol or thiopentone-isoflurane anaesthesia. Particular attention was focused on the recovery time needed to meet discharge criteria. The propofol group received propofol 2 mg.kg-1 for induction followed by propofol infusion (6-9 mg.kg-1.h-1) 1 min after intubation. ⋯ The propofol group had significantly (P less than 0.05) faster clinical recovery than the isoflurane group with respect to times to response to commands, eye opening, orientation, ability to stand and void, tolerance to oral fluids, "home-readiness", and recovery of perceptual speed. Patients in the propofol group had significantly less (P less than or equal to 0.05) emesis than the patients given isoflurane. We conclude that in patients undergoing ambulatory surgery propofol infusion is preferable to thiopentone-isoflurane anaesthesia, because it may allow faster discharge home.
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Acta Anaesthesiol Scand · Jul 1990
Randomized Controlled Trial Comparative Study Clinical TrialPost-dural puncture headache in young patients. A comparative study between the use of 0.52 mm (25-gauge) and 0.33 mm (29-gauge) spinal needles.
In a prospective study of 80 patients under 40 years of age, given spinal anaesthesia through either a 0.52 mm (25-gauge) needle or a 0.33 mm (29-gauge) needle, the incidence of post-dural puncture headache and backache was compared. There were no headaches in the 0.33 mm needle group, while in the 0.52 mm needle group an incidence of 25% was found. ⋯ The technique of performing spinal anaesthesia was evaluated and concluded to be slightly more difficult with a 0.33 mm needle, as estimated by the number of redirections of the needle needed to obtain cerebrospinal fluid. There were no differences between the two needles with respect to obtaining adequate spinal anaesthesia and spread of blockade.
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Acta Anaesthesiol Scand · Jul 1990
Randomized Controlled Trial Comparative Study Clinical TrialThe influence of pancuronium and vecuronium combined with balanced anaesthesia on haemodynamics and myocardial oxygen balance.
The effects of the non-depolarizing muscle relaxants pancuronium (Pancuronium) and vecuronium (Norcuron) (0.1 mg/kg) on myocardial blood flow, myocardial oxygen consumption, myocardial lactate balance, cardiovascular dynamics and electrocardiogram were studied in two groups of eight patients undergoing coronary artery bypass surgery. After induction of anaesthesia with 0.015-0.02 mg/kg flunitrazepam, isoflurane (0.5 vol%) and N2O/O2 (l/l), neuromuscular blockade was induced with pancuronium or vecuronium (0.1 mg/kg) combined with a single dose of 0.005 mg/kg fentanyl. Haemodynamic measurements were performed and the electrocardiogram was recorded before anaesthesia, in steady-state anaesthesia, after relaxation with pancuronium or vecuronium combined with fentanyl, and after intubation. ⋯ None of the other haemodynamic parameters differed significantly in either patient group. We did not observe ST-segment depressions or elevations in the ECG, increases in PCWP or myocardial lactate production. Therefore extended myocardial ischaemia can be excluded in our patients who received pancuronium or vecuronium for neuromuscular blockade.
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Acta Anaesthesiol Scand · Jul 1990
Lung fluid balance evaluated by the rate of change of extravascular lung water content.
Lung fluid balance was studied in 27 mongrel dogs by measuring changes in extravascular lung water content (EVLW). The expression delta EVLWi, which is the difference in EVLWi per kilo bodyweight per hour between two measurement occasions, was used as an estimate of the rate of change of EVLW. EVLW was measured by a double-indicator dilution technique (EVLWi) using iced glucose and indocyanine green. ⋯ OA-induced oedema caused a mean maximum delta EVLWi of 5.1 ml/kg/h, indicating capillary leakage which, however, was self-limiting within 2 h after OA injection. In hydrostatic oedema there was a maximum delta EVLWi of 16.0 ml/kg/h. Delta EVLWi was negative after deflation of the left atrial balloon, indicating reabsorption of oedema.
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Acta Anaesthesiol Scand · Jul 1990
Insufficient effect of local analgesics in Ehlers Danlos type III patients (connective tissue disorder).
The analgesic effects of intradermal lidocaine infiltration and topical EMLA cream applications (eutectic mixture of local anaesthetics) were studied in 8 patients with Ehlers Danlos syndrome type III, a heritable disorder of connective tissue, and in 8 controls. Cutaneous analgesia was evaluated by sensory and pain thresholds to short argon laser stimulation, and the depth of cutaneous analgesia was measured by sensory and pain thresholds to controlled needle insertion. Five minutes after lidocaine infiltration, the laser-induced pain was abolished in both groups, but 1 h later only the skin of the controls remained analgesic. ⋯ Full analgesia was obtained for the controls after 60 and 120 min of application. The depth of cutaneous EMLA analgesia was significantly less for the patients compared to controls. The present quantitative findings support clinical observations that long-lasting cutaneous analgesia is difficult to obtain for this group of patients.