Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 2000
Randomized Controlled Trial Clinical TrialThoracic epidural analgesia as an adjunct to general anaesthesia for cardiac surgery. Effects on pulmonary mechanics.
A lasting impairment of pulmonary function is common after cardiac surgery. Pain from the sternotomy may contribute to the impairment. Thoracic epidural analgesia (TEA) can efficiently relieve pain in the postoperative phase, but may also affect respiratory muscle function if local anaesthetics are used. We examined the effects of TEA on pulmonary function and ventilation at rest, before and after coronary artery bypass graft surgery (CABG). ⋯ A better pain-relief from TEA after CABG may improve the ability to cough by a greater expiratory muscle strength. FVC, FEV1, PImax and breathing at rest are not affected by TEA after cardiac surgery.
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Acta Anaesthesiol Scand · Oct 2000
Randomized Controlled Trial Clinical TrialEpidural infusion of bupivacaine and fentanyl reduces perioperative myocardial ischaemia in elderly patients with hip fracture--a randomized controlled trial.
Perioperative myocardial ischaemia is an important risk factor for cardiac morbidity and mortality after noncardiac surgery. The impact of analgesic management on the incidence and severity of cardiac ischemia was studied in 77 elderly patients undergoing surgical treatment of traumatic hip fracture. ⋯ Continuous epidural bupivacaine/fentanyl analgesic regimen, started preoperatively, reduces the amount of myocardial ischaemia in elderly patients with hip fracture.
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Acta Anaesthesiol Scand · Oct 2000
Randomized Controlled Trial Clinical TrialEfficacy of intrathecal neostigmine for the relief of postinguinal hemiorrhaphy pain.
Intrathecal administration of various doses of neostigmine has been reported to produce analgesia without neurotoxicity in both animal and human studies. The present study was undertaken to evaluate the efficacy and safety of intrathecal neostigmine for the relief of pain for patients having undergone inguinal herniorrhaphy surgery. ⋯ Our study showed that intrathecal neostigmine at 50 pg or 100 microg enhanced the onset of tetracaine anaesthesia and provided analgesia lasting for 6-9 h, although increased incidences of prolonged motor blockade and nausea or vomiting were noted.
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Acta Anaesthesiol Scand · Oct 2000
Randomized Controlled Trial Clinical TrialPreoperative ropivacaine infiltration in breast surgery.
The aim of the study was to investigate whether preoperative infiltration with ropivacaine in conjunction with breast surgery improves postoperative pain management and attenuates postoperative nausea and vomiting. ⋯ We found no differences in postoperative pain management between 3.75 mg/ml ropivacaine and saline wound infiltration before breast surgery. The data show similar postoperative needs of analgesics and antiemetics with a similar frequency of PONV.
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Acta Anaesthesiol Scand · Oct 2000
Randomized Controlled Trial Clinical TrialPharmacokinetics of 0.2% ropivacaine and 0.2% bupivacaine following caudal blocks in children.
Ropivacaine is the first S-enantiomer aminoamide local anaesthetic in clinical use, and has been found to be less toxic than bupivacaine. Caudal ropivacine has been shown to cause less motor blockade and longer duration of analgesia in the postoperative period than bupivacaine in children. Plasma levels of ropivacaine and bupivacaine have not been previously compared in children. This study was undertaken to compare the total venous plasma concentrations of similar doses of ropivacaine and bupivacaine following caudal administration. ⋯ Absorption and tissue distribution of ropivacaine is slower than for bupivacaine following caudal administration in children.