Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · May 2001
Randomized Controlled Trial Comparative Study Clinical TrialEase of laryngeal passage during fibreoptic intubation: a comparison of three endotracheal tubes.
The use of a fibreoptic bronchoscope to facilitate endotracheal intubation is well established in modern anaesthetic practice. Difficulty may be encountered when inserting an endotracheal tube over the fibrescope as the bevelled tip can impinge on the vocal cords or epiglottis and impede advancement through the laryngeal inlet. Intavent have recently developed a tapered tip tube for use with their Intubating Laryngeal Mask Airway. A randomised, double-blind study was performed to compare the ease of railroading three different tubes over a fibrescope placed in the trachea. ⋯ The Intavent tube was found to be superior for nasotracheal fibreoptic intubation to either the Mallinckrodt reinforced tube (P<0.034) or the Portex Blue Line tube (P<0.004).
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Acta Anaesthesiol Scand · May 2001
Randomized Controlled Trial Clinical TrialFentanyl does not improve the nerve block characteristics of axillary brachial plexus anaesthesia performed with ropivacaine.
The aim of this prospective, randomized, double-blind study was to evaluate the effects of adding 1 microg. kg-1 fentanyl to ropivacaine 7.5 mg. ml-1 for axillary brachial plexus anaesthesia. ⋯ The addition of fentanyl 1 microg. ml-1 to ropivacaine 7.5 mg. ml-1 does not improve the nerve block characteristics of axillary brachial plexus anaesthesia for orthopaedic procedures involving the hand.
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Acta Anaesthesiol Scand · May 2001
Randomized Controlled Trial Clinical TrialOnset and duration of action of rocuronium--from tracheal intubation, through intense block to complete recovery.
The primary objective of this study was to establish the relation between the post tetanic count (PTC) and the time to reappearance of the first response (T1) in train-of-four (TOF) nerve stimulation following rocuronium 0.6 mg/kg, 0.9 mg/kg, and 1.2 mg/kg. The secondary objective was to evaluate the intubation conditions after 1 min. ⋯ The PTC method can be used to predict the time to first response to TOF nerve stimulation during intense rocuronium induced neuromuscular blockade. The relation between PTC and the time to T1 was prolonged after 1.2 mg/kg compared with 0.6 mg/kg and 0.9 mg/kg. No further improvement in intubation conditions at 60 s was evident by increasing the rocuronium dose from 0.9 mg/kg to 1.2 mg/kg.
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Acta Anaesthesiol Scand · May 2001
Randomized Controlled Trial Clinical TrialClonidine decreases intraoperative bleeding in middle ear microsurgery.
The antihypertensive drug clonidine is a centrally acting alpha2 agonist useful as a premedicant because of its sedative, anxiolytic, and analgesic properties. We examined the effect of clonidine given as an oral preanesthetic medication in producing a bloodless surgical field in patients undergoing middle ear microsurgery. We also evaluated whether the administration of clonidine would alter the reflex cardiovascular response to laryngoscopy and endotracheal intubation, anesthetic requirement, postoperative pain intensity and consumption of analgesics, and pre- and postoperative sedation and anxiety. ⋯ Premedication with clonidine reduced bleeding in middle ear microsurgery, attenuated hyperdynamic response to tracheal intubation, and reduced isoflurane, fentanyl, and urapidil requirements for controlled hypotension.
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Acta Anaesthesiol Scand · May 2001
Randomized Controlled Trial Clinical TrialRopivacaine 1 mg/ml, plus fentanyl 2 microg/ml for epidural analgesia during labour. Is mode of administration important?
Patient-controlled epidural analgesia (PCEA) with a moderate to high concentration of bupivacaine in obstetrics has been shown to give comparable analgesia and even higher level of satisfaction compared to continuous epidural infusion. We hypothesised that the use of a very low concentration technique (ropivacaine/fentanyl) might result in excessive dosing in the PCEA group, more motor blockade and a negative impact on spontaneous delivery rate. ⋯ We conclude that epidural use of ropivacaine 1 mg/ml+fentanyl 2 microg/ml provides effective analgesia with equal volume requirements irrespective of administration mode, with a high spontaneous delivery rate. Choice of PCEA or CEI (continuous epidural infusion) should be directed by other considerations, most importantly compliance of midwife and possible reduction in workload for anaesthesiology staff.