Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Jun 1997
Randomized Controlled Trial Clinical TrialThe effect of halothane on mivacurium infusion requirements in adult surgical patients.
The extent of interaction between volatile anaesthetics and neuromuscular blocking agents depends both on the inhalational anaesthetic and the muscle relaxant. Halothane has the weakest potentiating effect on neuromuscular blocking drugs and previous studies of the interaction between halothane and mivacurium have been contradictory. We were interested in determining the effect of different levels of halothane-nitrous oxide anaesthesia on infusion requirements of mivacurium. ⋯ Halothane anaesthesia reduces mivacurium infusion requirements by 15-25% compared to nitrous oxide-fentanyl anaesthesia. Interindividual differences in the extent of this interaction are great.
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Acta Anaesthesiol Scand · Jun 1997
Randomized Controlled Trial Clinical TrialGranisetron reduces incidence of nausea and vomiting after breast surgery.
Postoperative nausea and vomiting (PONV) remains a troublesome problem. The study was performed to evaluate the antiemetic efficacy of prophylactic granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, on the incidence of PONV in patients undergoing general anaesthesia for breast surgery. ⋯ Granisetron is an effective antiemetic for preventing PONV in patients undergoing general anaesthesia for breast surgery.
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Acta Anaesthesiol Scand · Jun 1997
Randomized Controlled Trial Clinical TrialEvaluation of residual neuromuscular blockade using modified double burst stimulation.
To assess the degree of residual neuromuscular blockade, double burst stimulation (DBS) is commonly applied in the clinical setting. However, fades in response to DBS3,3 can rarely be identified manually when train-of-four (TOF) ratios are > or = 0.70, and, in contrast, fades in response to DBS3,2 are felt manually in an undesirably high proportion of cases, even at TOF ratios greater than 0.7. We investigated whether a new monitoring method, modified DBS, would be useful to determine an adequate degree of recovery from neuromuscular blockade. For modified DBS, two burst stimuli were applied at an interval of 750 ms. The first stimulation in the modified DBS consisted of two stimuli of 0.3 ms duration at 50 Hz and the second of two stimuli of 0.2 ms duration at 50 Hz. ⋯ Our results indicate that the modified DBS may be a useful stimulation pattern to diagnose the adequacy of recovery from neuromuscular blockade.
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Acta Anaesthesiol Scand · Jun 1997
Randomized Controlled Trial Clinical TrialGrading of severity of postdural puncture headache after 27-gauge Quincke and Whitacre needles.
Small-gauge needles are reported to have a low incidence of complications. Pencil-point needles are associated with a lower frequency of postdural puncture headache (PDPH), but a higher failure rate than Quincke needles. ⋯ We conclude that the 27-gauge Whitacre needle is the 'needle of choice' in patients with normal body stature. The incidence of PDPH following Quincke needles may not only be affected by the direction of the bevel during insertion but also during removal. Statistically, there was no gender variation in PDPH in this study (P = 0.5). A previous history of recurrent headache or migraine does not predispose to PDPH.
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Acta Anaesthesiol Scand · Jun 1997
Randomized Controlled Trial Clinical Trial2-Chloroprocaine antagonism of epidural morphine analgesia.
2-Chloroprocaine (2-CP) used for lumbar epidural anesthesia (LEA) reportedly decreases the efficacy of epidural morphine (EM) administered for post-cesarean section (CS) analgesia. The amount of supplemental i.v. morphine self-administered by the patient via the patient-controlled analgesia device (PCA) is used to study the interaction between EM and 2-CP. ⋯ Analgesic efficacy of EM is decreased when 2-CP is used for LEA compared to when Lido + Epi is used.