Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Aug 1997
Randomized Controlled Trial Clinical TrialAnalgesic and psychomotor effects of thiopental at subanesthetic concentrations in human volunteers.
Studies of the effects of barbiturates on the modulation of pain have produced mixed results. In a prospective, double-blind, randomized, placebo-controlled trial, we studied the effects of thiopental at presumed steady-state, "conscious sedation" levels on cold-pressor-induced pain in 12 healthy volunteers. ⋯ Our laboratory results do not support the long-held belief that barbiturates are "antanalgesic" or hyperalgesic, at least for cold-pressor-induced pain.
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Acta Anaesthesiol Scand · Aug 1997
Randomized Controlled Trial Clinical TrialCaudal clonidine and bupivacaine for combined epidural and general anaesthesia in children.
Clonidine produces analgesia by actions on alpha 2-adrenoceptors and enhances both sensory and motor blockade from epidural injection of local anaesthetics. Low-dose clonidine has been used so far for caudal injection in children. Our aim was to study the perioperative effects of high-dose caudal clonidine when added to low concentration of bupivacaine for combined epidural and general anaesthesia in children. ⋯ Our results suggest that caudal clonidine 5 micrograms.kg-1 enhances and prolongs caudal blockade with bupivacaine (1.175% in children. It also blocks sympathoadrenergic responses during emergence from anaesthesia. Sedation and cardiovascular effects are observed up to 3 h into the postoperative period.
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Acta Anaesthesiol Scand · Aug 1997
Relationship between intra- and postoperative oxygen transport and prolonged intensive care after cardiac surgery: a prospective study.
Prolonged intensive care is a rare but serious complication of cardiac surgery. It is required in less than 10% of operated patients but they use more than 30% of all the intensive care resources needed for cardiac surgery. The aim of our study was to describe the clinical course of the patients who need prolonged intensive care following cardiac surgery and to assess whether the intra- and postoperative oxygen transport variables are different in these patients as compared to patients with an uncomplicated course. ⋯ There was no significant relationship between the factors conventionally assumed to be risk factors for prolonged intensive care. Instead, an increase in whole body oxygen extraction, reflecting a mismatch between the whole body oxygen demand and supply, was associated with the need for prolonged intensive care. Oxygen extraction increased to compensate for the reduced oxygen delivery, which in turn was caused by a lower arterial oxygen content.
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Acta Anaesthesiol Scand · Aug 1997
Weight gain during pregnancy does not influence the spread of spinal analgesia in the term parturient.
It is still controversial whether the spread of spinal anaesthesia in pregnancy is influenced by particular physique. Investigation was based on a clinical observation that parturients with a pronounced "pregnant" physique, e.g. generalised oedema and heavy abdomen, tended to develop more cephalad sensory blockades than parturients without these physical signs. Using weight gain during pregnancy as a measure for the physique at term, we aimed to determine whether this parameter influences the distribution of analgesia after subarachnoidal injection of plain bupivacaine. ⋯ In parturients, weight gain during pregnancy, height, weight and body-mass index did not influence the extent of sensory analgesia after subarachnoidal administration of plain bupivacaine.
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Acta Anaesthesiol Scand · Aug 1997
Pharmacodynamic modelling of the analgesic effects of piritramide in postoperative patients.
The concentration-effect relationship of piritramide, a synthetic opioid analgesic predominantly used for postoperative analgesia and analgosedation, has not been reported so far. ⋯ The analgesic effect of piritramide was adequately described by an inhibitory fractional Emax-model. In order to overcome the pronounced hysteresis, piritramide should initially be administered as an intravenous bolus of at least 5 mg.