Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 1991
Randomized Controlled Trial Clinical TrialHaemodynamic responses and prolongation of QT interval of ECG after suxamethonium-facilitated intubation during anaesthetic induction in children: a dose-related attenuation by alfentanil.
The haemodynamic response to endotracheal intubation and changes in the QT interval of ECG during anaesthetic induction were studied in 68 healthy children (5.5 years). The children were pretreated double-blindly with either alfentanil 10 micrograms/kg (A10), 25 micrograms/kg (A25), 50 micrograms/kg (A50) or saline (control) (17 children in each group) i.v. 1 min before thiopentone 5 mg/kg. The trachea was intubated after suxamethonium 1.5 mg/kg. ⋯ The QT interval was significantly prolonged after suxamethonium in the control and A10 groups, but remained at baseline levels in the A25 and A50 groups. Ventricular ectopic beats were only seen in 2/17 children in the control group. In conclusion, alfentanil 25 microgram/kg is ideal for preventing the haemodynamic response to endotracheal intubation and prolongation of the QT interval, a sign of sympathoadrenal activation, before induction of intravenous anaesthesia in children.
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Acta Anaesthesiol Scand · May 1991
Randomized Controlled Trial Comparative Study Clinical TrialTracheal intubation after induction of anaesthesia with thiopentone or propofol without muscle relaxants.
This study was designed to compare the ease of performing laryngoscopy and endotracheal intubation without muscle relaxants after the induction of anaesthesia with either thiopentone or propofol in 106 patients scheduled for elective surgery. Thiopentone (5 mg/kg) or propofol (2.5 mg/kg), supplemented with lidocaine (1.5 mg/kg) and alfentanil (30 micrograms/kg), were used in random order for the induction of anaesthesia. ⋯ Visualisation of the larynx was good in 60 and 46% and intubation was easy in 48 and 22% of the patients given thiopentone and propofol, respectively (P less than 0.05 between groups for intubation). After induction of anaesthesia with thiopentone or propofol, endotracheal intubation is not recommended without the use of muscle relaxants.
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Acta Anaesthesiol Scand · May 1991
Randomized Controlled Trial Clinical TrialThe role of nitrous oxide in postoperative nausea and recovery in patients undergoing upper abdominal surgery.
The effect of nitrous oxide on postoperative nausea/vomiting and alertness were studied in 50 patients undergoing elective upper abdominal surgery. The study period lasted 20 h. Patients were randomly assigned to receive thiopentone-fentanyl-isoflurane-pancuronium anaesthesia with either 70% nitrous oxide-oxygen (Group I) or air-oxygen (Group II). ⋯ The postoperative alertness was tested by a visual analogue scale (0-10) for 6 h postoperatively. Omitting nitrous oxide did not decrease the frequency of postoperative nausea, although the symptoms were milder in the air group. The patients without nitrous oxide were alert earlier, in spite of a higher isoflurane concentration: VAS from 5 to 8.7 vs from 2.8 to 6.9 during the first 6 postoperative hours.
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Acta Anaesthesiol Scand · May 1991
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of intravenous ketoprofen with pethidine for postoperative pain relief following nasal surgery.
A controlled investigation was conducted to compare the efficacy of ketoprofen and pethidine in relief of postoperative pain after nasal surgery. Sixty patients were randomly allocated to receive intravenous ketoprofen 1.5 mg.ml-1 or pethidine 1 mg.kg-1 during induction of anaesthesia. Appearance, pain and headache were assessed 1, 2, and 4 h postoperatively, and the following morning. ⋯ Patients who received ketoprofen had significantly lower pain and headache scores (P less than 0.01 and P less than 0.001, respectively), and required significantly (P less than 0.05) less postoperative analgesia. No significant difference in incidence and severity of postoperative nausea or vomiting was found between the two groups at any time. A single intravenous dose of ketoprofen during anaesthesia may offer an advantage compared to pethidine in reducing postoperative pain following nasal surgery.
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Acta Anaesthesiol Scand · May 1991
Rebreathing during oxygen treatment with face mask. The effect of oxygen flow rates on ventilation.
The influence of different oxygen flow rates on ventilation and arterial blood gases was investigated in ten healthy volunteers during oxygen treatment with the Hudson mask. Respiratory parameters were calculated using inductive plethysmography calibrated against pneumotachography. The minute ventilation was greater when using the mask with oxygen flow rates less than 5 l/min compared to when no mask was used. ⋯ No change was seen, however, in PaCO2 with different oxygen flow rates. Secondary objective signs following an increase in respiratory work (changes in heart rate, systolic blood pressure and oxygen saturation) were not seen. We recommend 5 l/min as the lowest oxygen flow rate to be used during oxygen therapy with the Hudson mask, in order to avoid rebreathing and excessive respiratory work.