Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Mar 1999
Randomized Controlled Trial Clinical TrialIntra-articular morphine for pain relief after knee arthroscopy.
Peripheral opioid analgesia is well documented. But the clinical usefulness of intra-articular morphine after surgery is uncertain. The aim of the present study was to evaluate the analgesic effects of intra-articular morphine after knee arthroscopy. ⋯ Postoperative analgesic effect of intra-articular morphine was found only in a subgroup of patients with higher pain intensity in the immediate postanaesthetic period. Possible reasons for our overall negative findings include low study sensitivity due to weak pain stimulus, lack of inflammation that may be a prerequisite for peripheral opioid analgesia, and the local anaesthetic, which impedes local inflammatory reaction and expression of peripheral opioid receptors. These factors may also explain the conflicting results in other studies.
-
Acta Anaesthesiol Scand · Mar 1999
Randomized Controlled Trial Clinical TrialContinuous interscalene brachial plexus block for postoperative analgesia following shoulder surgery.
Severe postoperative pain is a well-known problem following shoulder surgery. This study evaluates the clinical efficacy of continuous interscalene brachial plexus block, patient-controlled analgesia, and morphine (i.v. and i.m.) for postoperative analgesia in this setting. ⋯ Successful continuous interscalene brachial plexus block provides very good pain relief following shoulder surgery and is superior to the other methods studied. However, we were unable to demonstrate a correlation between VAS pain scores and stress indicators in metabolic, circulatory and respiratory parameters.
-
Acta Anaesthesiol Scand · Mar 1999
Randomized Controlled Trial Clinical TrialEffects of sevoflurane and isoflurane anesthesia on arterial ketone body ratio and liver function.
The purpose of this study was to compare the effect on arterial ketone body ratio (AKBR), which indicates hepatic mitochondrial energy charge in relation to hepatic blood flow, and liver function test (serum levels of liver enzymes) between sevoflurane and isoflurane anesthesia. ⋯ Isoflurane induced an elevation of serum levels of liver enzymes more frequently than did sevoflurane 3 to 14 days after anesthesia, while AKBR until 12 h after anesthesia did not show any significant difference between sevoflurane and isoflurane anesthesia.
-
Acta Anaesthesiol Scand · Mar 1999
Randomized Controlled Trial Clinical TrialThe effect on intraocular pressure of endotracheal intubation or laryngeal mask use during TIVA without the use of muscle relaxants.
Depolarizing and non-depolarizing muscle relaxants possess many untoward side effects. In most patients endotracheal intubation may be performed with a propofol and alfentanil combination. The purpose of this study was to compare the effect on intraocular pressure (IOP) and haemodynamics of endotracheal (ET) intubation or laryngeal mask (LMA) insertion during total intravenous anaesthesia (TIVA) without the use of muscle relaxants. ⋯ During TIVA without the use of muscle relaxants neither LMA insertion nor ET intubation increased the IOP, but ET extubation did.