Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialWound infiltration with ropivacaine and bupivacaine for pain after inguinal herniotomy.
In a double-blind, randomized study, 32 patients scheduled for elective inguinal herniotomy under general anaesthesia received subcutaneous infiltration with 40 ml ropivacaine 2.5 mg/ml or bupivacaine. Postoperative pain intensity was assessed repeatedly for 24 hours at rest, during cough and movement on a visual analogue scale (VAS) and by means of pressure algometry. ⋯ The demand for analgesics was similar in the two groups. We conclude that incisional ropivacaine is as effective as bupivacaine in the management of post-herniotomy pain.
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Acta Anaesthesiol Scand · Jan 1995
Randomized Controlled Trial Clinical TrialFentanyl attenuates cardiovascular responses to tracheal extubation.
We carried out a controlled, randomized, double-blind study to examine the effects of intravenous fentanyl (1 or 2 micrograms kg-1) on hemodynamic changes during tracheal extubation and emergence from anesthesia in 60 ASA physical status I or II patients undergoing elective gynecological surgery. Anesthesia was maintained with 0.5%-1.5% isoflurane and 60% nitrous oxide (N2O) in oxygen. Muscle relaxation was achieved with vecuronium. ⋯ Postoperative somnolence and respiratory depression were not observed in any patients in any of the three groups. We concluded that a bolus dose of intravenous fentanyl 2 micrograms kg-1 given at the time of peritoneal closure was of value in attenuating the cardiovascular changes associated with tracheal extubation and emergence from anesthesia, and that this treatment did not prolong the recovery. However, further studies are required to assess this technique in patients with cardiovascular or cerebrovascular diseases.
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Acta Anaesthesiol Scand · Jan 1995
Randomized Controlled Trial Comparative Study Clinical TrialComparison of parenteral diclofenac and ketoprofen for postoperative pain relief after maxillofacial surgery.
Non-steroidal anti-inflammatory drugs (NSAID) effectively reduce the need for opioid analgesia after various types of surgery. The efficacy of diclofenac and ketoprofen to relieve pain after maxillofacial surgery was compared in the present study. In a randomized and double-blind fashion, 90 ASA I-II patients (16-60 yrs) were studied, divided into three groups: Thirty patients received 1.0 mg.kg-1 diclofenac i.v. after general anaesthesia induction, before surgical incision, and four hours later the same dose was given i.m. ⋯ Overall, there was a lower need for i.v. oxycodone during the 24-hour period in the diclofenac group (269 doses) than in the ketoprofen group and in the saline group (388 doses, each) (P < 0.01). The significantly lower number of oxycodone administrations in the diclofenac group was a result of a distinguishable difference, particularly during the first four hours after surgery. There was no statistically significant difference in the incidence of side effects of the analgesic therapy between the three groups.
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Acta Anaesthesiol Scand · Jan 1995
Case ReportsLaryngeal mask airway guided tracheal intubation in a neonate with the Pierre Robin syndrome.
Endotracheal intubation in infants with the Pierre Robin syndrome may sometimes be impossible to accomplish by conventional means. To aid difficult tracheal intubation many different techniques have been described. We present a case, in which we successfully intubated a small-for-date newborn boy with the Pierre Robin syndrome by using a modified laryngeal mask airway (no. 1) as a guide for the endotracheal tube. The technique is easy to perform, less traumatic and less time-consuming than multiple attempts at laryngoscopy or blind tracheal intubation.
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Acta Anaesthesiol Scand · Jan 1995
Reexpansion of atelectasis during general anaesthesia may have a prolonged effect.
Pulmonary atelectasis, as found during general anaesthesia, may be reexpanded by hyper-inflation of the lungs. The purpose of this study was to determine whether such a recruitment is maintained and whether this is accompanied by an improved gas exchange. We studied a consecutive sample of twelve lung healthy adults, scheduled for elective surgery. ⋯ During general anaesthesia in lung healthy patients, most of the reexpanded atelectatic lung tissue remains inflated for at least 40 min. The recruitment manoeuvre decreases pulmonary shunt, but increases low VA/Q. The net effect on gas exchange is a small reduction of PA-aO2.