Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1991
Randomized Controlled Trial Comparative Study Clinical TrialComparison of intravenous and topical lidocaine as a suppressant of coughing after bronchoscopy during general anesthesia.
Twenty-four consecutive patients scheduled for fiberbronchoscopy were randomized to receive double-blind either intravenous (1.5 mg/kg) or laryngotracheal (3 mg/kg) lidocaine to evaluate the influence on post-bronchoscopic laryngospasm, pain in the throat and coughing. Plasma lidocaine concentrations were analyzed 5, 15, 30 and 60 min after administration. ⋯ The plasma lidocaine concentrations were significantly higher after intravenous than after topical administration (P less than 0.001). After intravenous administration the plasma lidocaine concentrations exceeded the accepted level for potential toxicity in five out of 11 patients, but none of the patients developed toxic symptoms and no side-effects were observed.
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Acta Anaesthesiol Scand · Apr 1991
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the haemodynamic effects of pipecuronium and pancuronium during fentanyl anaesthesia.
Haemodynamic variables were measured following administration of pipecuronium 70 micrograms.kg-1 and pancuronium 90 micrograms.kg-1 (approximately equivalent to 1.5 x ED95) in patients anaesthetised with fentanyl 50 micrograms.kg-1 and scheduled to undergo coronary artery bypass grafting. There were significant increases in heart rate (22%), mean arterial pressure (10%), cardiac index (16%), and the rate pressure product (35%) following administration of pancuronium. The absolute values of these parameters were, however, within acceptable clinical limits. ⋯ Other measured or derived indices showed only small changes with both agents and these were generally insignificant. There were no incidences of significant bradycardia following pipecuronium administration. The results from the present study suggest that pipecuronium would have advantages for use in patients with significant cardiovascular disease.
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Acta Anaesthesiol Scand · Apr 1991
Postoperative patient-controlled analgesia with sufentanil: analgesic efficacy and minimum effective concentrations.
Sufentanil has so far seldom been used for intravenous postoperative patient-controlled analgesia (PCA), and the resulting serum concentrations have not yet been determined. Forty ASA I-III patients recovering from major gynecological operations were investigated to evaluate analgesic efficacy, side effects, patient acceptance and threshold concentrations of sufentanil in serum during the early postoperative period, using the On-Demand Analgesia Computer (ODAC). Following an individualized intravenous loading dose of 19.1 +/- 35.7 micrograms (mean +/- 1 s.d.), sufentanil demand doses were 6 micrograms with a concurrent infusion of 1.15 micrograms/h and a maximum hourly dose of 40 micrograms/h; the lockout time was set to 1 min. ⋯ Intraindividual MEC variability was slightly lower than intersubject variability (76.0 vs. 84.8%). It is concluded that sufentanil is suitable for postoperative PCA. To get into the therapeutic window for analgesia, a serum sufentanil concentration of more than 0.03 ng/ml seems to be necessary.
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Acta Anaesthesiol Scand · Apr 1991
Randomized Controlled Trial Comparative Study Clinical TrialComparison of standard and high-dose adrenaline in the resuscitation of asystole and electromechanical dissociation.
Sixty-eight adults with cardiac arrest (asystole and electromechanical dissociation) were randomly allocated for treatment with standard (1 mg) or high-dose epinephrine (5 mg). If the first dose of adrenaline (1 or 5 mg) failed, standardized advanced life-support was applied in all cases. ⋯ Blood pressure was significantly higher in the high-dose adrenaline group in comparison to the standard dose at 1 and 5 min after resuscitation. Although high-dose adrenaline appears to improve cardiac resuscitation success, the duration of global cerebral ischaemia seems to determine the ultimate outcome.