Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 1991
Randomized Controlled Trial Comparative Study Clinical TrialPremedication before elective breast surgery, a comparison between ketobemidone and midazolam.
One hundred female patients scheduled for elective breast surgery (mean age 60 +/- 11 years were randomly assigned to receive one of two premedications: ketobemidone (Ketogan) 1-1.5 ml or midazolam 4-5 mg, intramuscularly. The effects on preoperative anxiety and postoperative emetic sequelae were studied. All patients were anaesthetised with thiopentone, fentanyl and atracurium, and ventilated with a mixture of nitrous oxide in oxygen with supplementary isoflurane. ⋯ No difference was seen in the frequency of emetic sequelae: 20 patients in the midazolam group and 14 patients in the ketobemidone group vomited once or more during the 24-h observation period. There was no difference between the two groups in time until an analgetic was required. In conclusion, midazolam seemed more effective in reducing preoperative anxiety than ketobemidone without any negative effects on postoperative emesis or time until an analgetic was required.
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Acta Anaesthesiol Scand · Aug 1991
Randomized Controlled Trial Clinical TrialContinuous epidural infusion of bupivacaine and morphine for postoperative analgesia after hysterectomy.
The analgesic efficacy and side-effects of combined epidural infusion of bupivacaine and morphine, in comparison with these drugs alone, for postoperative analgesia after hysterectomy (60 patients) were evaluated. Before general anaesthesia, all patients had an epidural catheter placed (Th11-12) and 20 ml of 0.5%, bupivacaine was injected. In random order, epidural infusion was continued for 24 h with either 0.25% bupivacaine 4 ml.h-1 (BUPI-group), a bolus of 2 mg of morphine followed by morphine 0.2 mg.h-1 (MO-group), or a combination of the two drugs (COMB-group). ⋯ In the postoperative evening and the first postoperative morning, the corresponding figures were 7/20 and 10/20 in the BUPI-group, 15/20 and 15/20 in the MO-group, and 18/20 and 15/20 in the COMB-group (postop, evening; P less than 0.01 BUPI vs. others). The number of patients requiring supplementary analgesics (morphine and indomethacin during the first 24 h was greatest in the BUPI-group P less than 0.01). The number of patients who vomited during the 24-h period was 3 in the BUPI-group, 9 in the MO-group and 5 in the COMB-group.(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · Aug 1991
Comparative StudyComparison of North American and European malignant hyperthermia group halothane contracture testing protocols in swine.
Different in vitro halothane testing procedures have been used in the European malignant hyperthermia (MH) Group Protocol (EMHGP) and the North American MH Group Protocol (NAMHGP), whereas the caffeine-testing protocols are very similar. The present study compares the two halothane-testing protocols in ten MH susceptible swine and in four control swine. Halothane contracture testing was conducted in vitro 12-52 days following the barnyard challenge that established the MH susceptibility of the swine. ⋯ While some skeletal muscle strips from MH pigs were normal by both protocols (NAMHGP 30%; EMHGP 10%), the outcome of halothane testing by the NAMHGP was unaffected. The response to halothane 3% is reduced if preceded by the EMHGP, suggesting that simply adding halothane 3% to the end of the EMHGP does not permit a direct quantitative comparison to the NAMHGP. However, the diagnostic outcomes of the two approaches are similar.
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Acta Anaesthesiol Scand · Aug 1991
Randomized Controlled Trial Comparative Study Clinical TrialChanges in body heat during hip fracture surgery: a comparison of spinal analgesia and general anaesthesia.
Postoperative hypothermia initiates an increased oxygen demand in the postoperative period and may endanger patients with restricted cardiopulmonary reserves. In order to compare net heat losses and gains, we studied 28 women undergoing hip fracture surgery, using either general anaesthesia or spinal analgesia. ⋯ Temperature changes were unrelated to the type of anaesthesia. Large net heat losses occurred on transfer to the recovery room.