Acta anaesthesiologica Scandinavica
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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
Multicenter StudyMaternal expectations and experiences of labour pain--options of 1091 Finnish parturients.
A prospective survey of 1091 Finnish parturients was conducted in order to ascertain mothers' expectations for labour pain relief, to measure the actual pain during all three stages of labour and to question their satisfaction and the adequacy of pain relief on the third day following delivery. Antenatal expectations for pain relief were surveyed. Mothers were questioned on pain levels in the delivery room and 3 days after giving birth. ⋯ In the delivery room over 80% of all parturients described their pain as very severe to intolerable, only 4% of the multiparous had low pain scores (0-2). After pain treatment 50% of multiparous women still had pain scores from 8 to 10, which reflects a lack of effective pain relief. Dissatisfaction with the childbirth experience was very low, and was associated with instrumental deliveries, but not with the usage of analgesia. 51% of all parturients complained of inadequate pain relief during childbirth, which, in multiparous women, was significantly associated with the second stage of labour.
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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.
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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.