Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 1993
Randomized Controlled Trial Comparative Study Clinical TrialCervical epidural steroid injection for cervicobrachialgia.
Fifty patients with chronic resistant cervicobrachialgia were randomly divided into two groups. Twenty-five patients (group A) were treated with cervical epidural steroid/lidocaine injections and 17 patients (group B) were treated with steroid/lidocaine injections into the posterior neck muscles. Another eight patients from group B were excluded from the study because they had started the process of litigation of insurance claims and their subjective analysis of pain relief might therefore not be trustworthy. ⋯ These differences were statistically significant. We failed to achieve significant improvement of tendon reflexes or of sensory loss in both groups, but the increase in the range of motion, the fraction of patients who were able to decrease their daily dose of analgesics, and recovery of the capacity for work were significantly better in group A. We encountered no complications in either group of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · Aug 1993
Randomized Controlled Trial Clinical TrialAnaesthesia for coronary artery bypass grafting: opioid-analgesia combined with either flunitrazepam, propofol or isoflurane.
This is a prospective, open, randomized study comparing three different anaesthetic regimens with respect to haemodynamic stability (cardiac index and pressure measurements), ischaemia (ECG), and loss of awareness (midlatency auditory evoked potentials in 58 patients undergoing coronary artery surgery. Anaesthesia was based on fentanyl 0.01 mg kg-1 bw for induction and 0.8-2.0 mg h-1 in combination with nitrous oxide for maintenance before cardiopulmonary bypass and 0.2-0.6 mg h-1 without nitrous oxide during and after cardiopulmonary bypass. Eighteen patients were anaesthetised with flunitrazepam 0.01 mg kg-1 bw for induction and received thereafter 1-2 mg h-1 for maintenance (group F). ⋯ Surgery and sternotomy caused an increase in SVI and APs/SV in all groups. Differences between the groups were only found for systemic pressures, which after sternotomy were lowest in group I and before cardiopulmonary bypass were highest in group F. After termination of bypass all groups showed an increase in HR and a decrease in SVI, SVR, and LVSWI compared to the awake state, while CI remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · Aug 1993
Randomized Controlled Trial Comparative Study Clinical TrialEvaluation of postural stability by computerised posturography following outpatient paediatric anaesthesia. Comparison of propofol/alfentanil/N2O anaesthesia with thiopentone/halothane/N2O anaesthesia.
Simple clinical tests, like Romberg's test or a walking test, have proved to be inadequate guidelines for safe discharge after outpatient anaesthesia. A randomised study was therefore planned to compare postural stability measured by computerised posturography in 31 oral midazolam-atropine premedicated children aged 6.9 (s.e. 0.4) years who had been anaesthetised with either propofol/alfentanil/N2O or thiopentone/halothane/N2O. The sway velocity of the children was measured before premedication and 1, 2 and 3 h after the end of anaesthesia. ⋯ The quantified version of the Romberg test performed with eyes open or closed was not impaired after anaesthesia, compared with the control values, indicating that in children poor equilibrium is not compensated by vision. The clinical recovery with respect to the times to eye opening, to responding to command or to being fully awake did not differ between the two anaesthesia methods. On the basis of recovery assessed by postural stability, propofol/alfentanil/N2O anaesthesia was not preferable to thiopentone/halothane/N2O anaesthesia after minor paediatric otolaryngological surgery.
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Acta Anaesthesiol Scand · Aug 1993
Randomized Controlled Trial Comparative Study Clinical TrialA double-blind comparison of lidocaine and mepivacaine during epidural anaesthesia.
The effects of epidural anaesthesia with plain 2% lidocaine or mepivacaine were compared in 200 patients undergoing extracorporeal shock wave lithotripsy in a double-blind manner. The onset, spread, duration and quality of analgesia were similar in both groups. The numbers of patients who needed vasoconstrictor or atropine were almost equal in both the lidocaine and the mepivacaine groups. ⋯ A transient decrease in arterial oxygen saturation was seen in two patients receiving lidocaine and in three patients receiving mepivacaine. Mild systemic toxicity was observed in eight patients in both groups, although serious complications such as convulsions did not occur. It is concluded that both drugs can be used equally safely for epidural anaesthesia, although the maximum recommended doses differ.