Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 1995
Randomized Controlled Trial Comparative Study Clinical TrialIs the pencil point spinal needle a better choice in younger patients? A comparison of 24G Sprotte with 27G Quincke needles in an unselected group of general surgical patients below 46 years of age.
Reports have indicated that there are less postoperative complaints after the use of pencil pointed spinal needles. We compared a 24G Sprotte needle with a 27G Quincke needle in a randomised study of 200 healthy patients (49% females), aged 15-46 years. Four patients (2%) reported postdural puncture headache, three with the 24G Sprotte needle and one with the 27G Quincke needle. ⋯ Of the 57 (29%) who reported backpain, a significantly higher proportion had received spinal anaesthesia with the Sprotte needle (OR = 2.06). There was a significantly higher incidence of insufficient blocks after dural puncture with the Sprotte needle. Ease of needle insertion and number of puncture attempts was the same for both needle types.
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Acta Anaesthesiol Scand · May 1995
Randomized Controlled Trial Comparative Study Clinical TrialComparison of eltanolone and thiopental in anaesthesia for termination of pregnancy.
Eltanolone, a new steroid hypnotic, was compared to thiopental in short anaesthesia. Sixty unpremedicated, Asa 1-2 women were randomized to receive eltanolone 0.6 (group E1) or 0.8 mg.kg-1 (group E2) or thiopental 4 mg.kg-1 (group T) for induction of anaesthesia. One minute before induction glycopyrrolate 0.2 mg and alfentanil 15 micrograms.kg-1 i.v. were administered. ⋯ Side effects were few in all groups, but involuntary muscle movements or hypertonus occurred in 23% of the patients in the eltanolone and in 3% in the thiopental groups (n.s). Early recovery (eye opening, orientation and sitting) was slower in both eltanolone groups compared to the thiopental group (P < 0.01). No differences between the groups were found in toleration of oral fluids, walking, voiding, postoperative analgesic requirements or postoperative nausea and vomiting.(ABSTRACT TRUNCATED AT 250 WORDS)
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Acta Anaesthesiol Scand · May 1995
Randomized Controlled Trial Clinical TrialQuantifying the interaction of vecuronium with enflurane using closed-loop feedback control of vecuronium infusion.
The influence of different levels of enflurane anaesthesia on infusion requirements of vecuronium was studied in 40 adult surgical patients. Ninety percent neuromuscular block was maintained by computer controlled infusion of vecuronium. During the first 90 min study period all patients received fentanyl-nitrous oxide-oxygen (2:1) anaesthesia. ⋯ In group II the infusion rate lowered from 80 +/- 28 to 56 +/- 20 micrograms.kg-1.h-1, in group III from 61 +/- 29 to 34 +/- 17 micrograms.kg-1.h-1 and in group IV from 65 +/- 20 to 30 +/- 14 micrograms.kg-1,h-1. In the control group the infusion rate decreased during the three hour study period from 69 +/- 17 (first 90 min period) to 59 +/- 16 micrograms.kg-1.h-1 (second 90 min period). Enflurane reduces the dose requirements of vecuronium administered by continuous infusion in a dose- and time-dependent manner.
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Acta Anaesthesiol Scand · May 1995
A simplified concept for controlling oxygen mixtures in the anaesthetic machine--better, cheaper and more user-friendly?
Modern anaesthetic machines are equipped with several safety components to prevent delivery of hypoxic mixtures. However, such a technical development has increased the complexity of the equipment. We report a reconstructed anaesthetic machine in which a paramagnetic oxygen analyzer has provided the means to simplify the apparatus. ⋯ These devices have been replaced by a simple safety system using a paramagnetic oxygen analyzer at the common gas outlet, which in a feed-back system cuts off the supply of nitrous oxide whenever the oxygen concentration falls below 25%. The simplified construction of the anaesthetic machine has important consequences for safety, cost and user-friendliness. Reducing the complexity of the construction also simplifies the pre-use checkout procedure, and an efficient 5-point check list is presented for the new machine.
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Acta Anaesthesiol Scand · May 1995
Randomized Controlled Trial Comparative Study Clinical TrialAnaesthesia for short outpatient procedures. A comparison between thiopentone and propofol in combination with fentanyl or alfentanil.
We studied supplementation of propofol or thiopentone anaesthesia with 0.5 or 1.0 mg alfentanil or 0.05 or 0.1 mg fentanyl for minor gynaecological outpatient procedures. Four hundred patients scheduled for elective termination of pregnancy were randomly allocated to one of eight groups. Induction agent doses, peroperative complications, complaints about pain and emesis during the postoperative period, and time to discharge were studied. ⋯ The need for postoperative reserve analgesics was less in the alfentanil group (P < 0.05). We found, however, no major differences between the supplementations tested regarding the total dose of induction agent, emesis or time to discharge. Supplementation with 1.0 mg of alfentanil to propofol was found to be the best combination tested for short outpatient procedures.