Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jul 1996
Randomized Controlled Trial Comparative Study Clinical TrialPreoperative application of piroxicam gel compared to a local anaesthetic field block for postoperative analgesia.
The non-steroidal anti-inflammatory drugs inhibit prostaglandin synthesis and hence have an analgesic action. Following topical administration, the drug is concentrated in the tissues and so can have a local analgesic effect. This study investigated the effect of the preoperative application of topical piroxicam on postoperative analgesic requirement compared to a placebo group and a conventional local anaesthetic field block. ⋯ There were no apparent NSAID-induced side-effects, or effects on wound healing. The preoperative administration of piroxicam (15gm) topically compared favourably with a preoperative local anaesthetic field block with respect to VAS scores, time to first analgesia and total morphine consumption. And both treatment groups provided significantly superior analgesia than the control group.
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Acta Anaesthesiol Scand · Jul 1996
Response to double-burst appears before response to train-of-four stimulation during recovery from non-depolarizing neuromuscular blockade.
Double-burst stimulation (DBS) it a relatively new nerve stimulation mode introduced for improved manual detection of residual neuromuscular blockade. Previous studies have shown that DBS3,3 50/50 (3 stimuli at 50 Hz followed 0.75 seconds later by 3 stimuli at 50 Hz) can detect deeper degrees of neuromuscular blockade than train-of-four (TOF) stimulation. ⋯ DBS3,3 80/40 is capable of detecting deeper degrees of blockade than DBS3,3 50/50, which again is capable of detecting deeper degrees of blockade than TOF.
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Acta Anaesthesiol Scand · Jul 1996
Randomized Controlled Trial Clinical TrialIntravenous ketoprofen for pain relief after total hip or knee replacement.
There are few studies in which ketoprofen, a propionic acid derivate NSAID, has been tested as an intravenous postoperative analgesic. The aim of this double-blind, randomized, placebo-controlled work was to study the tolerability and efficacy of intravenous ketoprofen in seventy-six patients undergoing hip or knee total endoprothesis surgery using three different doses. ⋯ A bolus of ketoprofen following continuous infusion of ketoprofen, coupled with a PCA-system, was an effective and safe approach for the relief of postoperative pain.
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Acta Anaesthesiol Scand · Jul 1996
Randomized Controlled Trial Clinical TrialThe effect of topical lignocaine on intubating conditions after propofol-alfentanil induction.
Recent studies have found satisfactory conditions for intubation of the trachea without using muscle relaxants using an intravenous technique combining propofol and alfentanil. In this study we evaluate intubating conditions with this method and either lignocaine applied topically in the larynx and trachea or placebo. ⋯ Induction of anaesthesia with propofol 2.5 mg/kg and alfentanil 30 micrograms/kg combined with 4 ml of lignocainespray 40 mg/ml into the larynx and trachea offered consistent and satisfactory intubation conditions. We thus recommend this method for tracheal intubation, where the use of muscle relaxants is not indicated.
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Acta Anaesthesiol Scand · Jul 1996
Randomized Controlled Trial Comparative Study Clinical TrialContinuous thoracic epidural analgesia versus combined spinal/thoracic epidural analgesia on pain, pulmonary function and the metabolic response following colonic resection.
The neuroendocrine response following major surgery has not been previously influenced by either regional anaesthetic techniques or opioid analgesia probably due to insufficient intraoperative afferent neural blockade. In this study we attempted to determine whether significant inhibition of these pathways could be achieved by combining preoperative high spinal anaesthesia with postoperative thoracic epidural anaesthesia. In theory too, there may be additional benefits over perioperative thoracic epidural anaesthesia on pain and pulmonary dysfunction. ⋯ Thoracic epidural bupivacaine/diamorphine infusion provided excellent postoperative analgesia following colonic surgery. An intraoperative combined spinal/epidural technique conferred no additional benefit on analgesia, pulmonary function and the neuroendocrine response.