Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Apr 1995
Randomized Controlled Trial Comparative Study Clinical TrialRecovery from sevoflurane and isoflurane anaesthesia after outpatient gynaecological laparoscopy.
As the low blood solubility (blood gas partition coefficient 0.69) of sevoflurane suggests a rapid emergence from anaesthesia, recovery from sevoflurane anaesthesia was compared to isoflurane in outpatient gynaecological laparoscopy. Fifty ASA I or II, consenting women participated in a randomised, controlled and single blind study. The patients received, after induction of anaesthesia with propofol, either sevoflurane or isoflurane, both with 67% nitrous oxide in oxygen, for maintenance of anaesthesia. ⋯ The subjects were able to open eyes in 2.3 (0.8-7.0) min and 4.1 (2.0-6.8) min, orientate in 2.8 (1.0-6.8) min and 4.7 (2.2-8.3) min and follow orders in 2.6 (0.7-6.8) min and 4.3 (1.2-7.3) min, in the sevoflurane and isoflurane groups, respectively (P < 0.05) [median (range)]. Walking was achieved in 72 (24-464) min and 66 (35-134) min, tolerance of oral fluids in 37 (15-88) min and 35 (45-161) min and voiding in 262 (96-459) min and 217 (52-591) min in the sevoflurane and isoflurane groups, respectively (NS). Overall home readiness was achieved in 281 (96-708) min after sevoflurane group and 242 (96-591) min after isoflurane (NS).(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · Apr 1995
Randomized Controlled Trial Comparative Study Clinical TrialComparison of induction time and characteristics between sevoflurane and sevoflurane/nitrous oxide.
A previous investigation using nitrous oxide with 5% enflurane (3.8 MAC) for single breath induction produced a stage of excitement which may be related to the difference in blood/gas coefficient solubility of these agents. The closer blood/gas solubility coefficient of sevoflurane and nitrous oxide may eliminate this phenomenon. We therefore evaluated 40 volunteers in a randomized study using 7.5% sevoflurane (3.7 MAC) in oxygen (n = 21) or sevoflurane with nitrous oxide (n = 19) using a single breath induction technique. ⋯ This was, however, not statistically significant. There were scarcely induction-related complications, such as coughing, laryngospasm, breath-holding, movements of a limb and excessive salivation, in either group. Thus, the addition of nitrous oxide neither increased the number of complications, nor the speed of induction.
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Acta Anaesthesiol Scand · Apr 1995
Randomized Controlled Trial Clinical TrialTrain-of-four recovery after pharmacologic antagonism of pancuronium-, pipecuronium-, and doxacurium-induced neuromuscular block in anaesthetized humans.
Previous studies have suggested that the increased duration of action of long-acting neuromuscular relaxants may make their pharmacologic antagonism more difficult and, thus, increase the likelihood of residual block. This hypothesis was tested in healthy, adult humans who received a background of isoflurane/N2O/fentanyl anaesthesia. Study subjects were paralyzed with either pancuronium (N = 8), pipecuronium (N = 8), or the longer-acting relaxant, doxacurium (N = 8). ⋯ Spontaneous recovery to 25% of the baseline T1 response occurred at 52 +/- 14 min (mean +/- SD) following administration of either pancuronium and pipecuronium, and 85 +/- 33 min following doxacurium (P < 0.05 for doxacurium versus pancuronium and pipecuronium). In doxacurium-treated patients, reversal of block with neostigmine was less predictable and less complete than with the other two relaxants. For example, the ratio of the fourth to first twitch (T4/T1) of the TOF at 10 and 15 min after reversal was significantly less with doxacurium (59 +/- 14% and 61 +/- 16%, respectively) than with either pancuronium (75 +/- 6% and 75 +/- 10%) or pipecuronium (76 +/- 9% for both).(ABSTRACT TRUNCATED AT 250 WORDS)