Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 1994
Randomized Controlled Trial Comparative Study Clinical TrialAn assessment of prilocaine as a topical anaesthetic agent for fibreoptic bronchoscopy in comparison with lidocaine.
We have evaluated prilocaine as a topical anaesthetic agent for fibreoptic bronchoscopy in comparison with lidocaine in terms of efficacy and safety. Forty patients were included in a randomised double-blind parallel-group study. Efficacy was assessed using visual analogue scales, a patient ranking scale and the number of doses of local anaesthetic and intravenous sedative required. ⋯ However, the median peak plasma concentration of prilocaine (0.5 micrograms.ml-1) was less than one-third that of lidocaine (1.76 micrograms.ml-1). The merits and hazards of using multiple-regression modelling to improve the precision of the analysis of the results are considered. We conclude that prilocaine can be used successfully as a topical anaesthetic agent for fibreoptic bronchoscopy and is associated with a lower risk of toxicity.
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Acta Anaesthesiol Scand · Jul 1994
Randomized Controlled Trial Comparative Study Clinical TrialThe haemodynamic response to the insertion of the laryngeal mask airway: a comparison with laryngoscopy and tracheal intubation.
The haemodynamic response to the insertion of the laryngeal mask airway (LMA) was assessed and compared to that of laryngoscopy and tracheal intubation in a study of forty patients (ASA 1) randomly allocated into two groups and anaesthetised using a standard balanced anaesthetic technique. The results show that the changes in all cardiovascular parameters measured following LMA insertion were significantly less (P < 0.05) when compared with those following laryngoscopy and tracheal intubation. We conclude that airway management with the LMA may be used to avoid the haemodynamic response to tracheal intubation where such a response is undesirable.
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Acta Anaesthesiol Scand · Jul 1994
Comparative StudyOn the relative potency of amino-amide local anaesthetics in vivo.
With the aim of comparing the analgesic effectiveness of lidocaine, prilocaine, bupivacaine and etidocaine in vivo, a study of the relationships between dose and duration of infraorbital nerve block (IONB) of various intensities (IONB degrees 3-10) was performed in the rat. With increasing doses longer durations of action were obtained. Further analyses were performed using multiple regression analysis. ⋯ The difference between these agents with respect to their duration of action at all dose levels amounted to 11 +/- 3 minutes (M +/- s.e.m.) for etidocaine vs. lidocaine (IONB degree 10), 27 +/- 4 min for prilocaine vs. lidocaine and 54 +/- 5 min for bupivacaine vs. etidocaine (IONB degree 3). For all other comparisons the log (dose)-duration lines deviated from parallelism, i.e. differences between agents with respect to their duration of action were found to be dose-dependent. The slopes of the log (dose)-duration lines were found to correlate closely to the log (partition coefficient) and log (protein binding) of the investigated agents.
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Acta Anaesthesiol Scand · Jul 1994
Central-to-peripheral arterial pressure gradient during cardiopulmonary bypass: relation to pre- and intra-operative data and effects of vasoactive agents.
A significant central-to-peripheral arterial pressure gradient may exist during and after cardiopulmonary bypass (CPB). The etiology and mechanisms of this phenomenon remain controversial. We studied the pressure gradient between aorta, brachial artery and radial artery in 68 patients, scheduled for elective coronary artery bypass surgery. ⋯ There was also no relation between magnitude of the pressure gradient and type of cardioprotection, choice of pulsatile vs nonpulsatile flow on CPB and duration of CPB. We also found no relation between pressure gradients and changes in temperature, haematocrit and systemic vascular resistance. The pressure gradient was not affected by any of the vasoactive drugs.
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Acta Anaesthesiol Scand · Jul 1994
Randomized Controlled Trial Clinical TrialIbuprofen in the treatment of postoperative pain in small children. A randomized double-blind-placebo controlled parallel group study.
The efficacy of ibuprofen as a pre-emptive analgesic for postoperative pain was investigated in 81 children in the age between one and four years subjected to elective surgery. The patients were randomized into two groups receiving rectally either ibuprofen 40 mg.kg-1.d-1, divided into four equal doses, or placebo in a double blind manner. Additional pain relief was provided by morphine. ⋯ Heart rate and arterial blood pressure were lower in children who received ibuprofen, probably reflecting better analgesia. The side effects were mild and similar in both groups. We conclude that rectal ibuprofen is a safe analgesic in children in the age between 1 and 4 years and reduces the need of opioids for postoperative pain relief.