Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Nov 2004
Randomized Controlled Trial Comparative Study Clinical TrialClonidine vs. midazolam as premedication in children undergoing adeno-tonsillectomy: a prospective, randomized, controlled clinical trial.
Clonidine administration in the setting of paediatric anaesthesia is associated with a number of desirable effects, e.g. preoperative sedation, analgesia and reduced anaesthetic requirements. The aim of the current study was to compare postoperative outcome variables using a prospective, randomized, double-blind design after premedication with clonidine or midazolam. ⋯ Rectal premedication with clonidine was associated with a significant reduction of pain in the early postoperative period compared to midazolam and was also associated with moderately increased sedation during the first 24 postoperative hours. The sedative effect of clonidine is in agreement with the unambiguous finding of a parental preference for a calm and sedated child during the first 24 postoperative hours.
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Acta Anaesthesiol Scand · Nov 2004
Randomized Controlled Trial Clinical TrialEffects of subanaesthetic and anaesthetic doses of sevoflurane on regional cerebral blood flow in healthy volunteers. A positron emission tomographic study.
We tested the hypothesis that escalating drug concentrations of sevoflurane are associated with a significant decline of cerebral blood flow in regions subserving conscious brain activity, including specifically the thalamus. ⋯ At sevoflurane concentrations at 0.7% and 2.0% a significant decrease in relative rCBF was detected in the thalamus. Interestingly, some of the most profound changes in rCBF were observed in structures related to pain processing (anterior cingulate and insula).
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Acta Anaesthesiol Scand · Nov 2004
Comment Historical ArticleFurther commentary on Denmark's 1952-53 poliomyelitis epidemic, especially regarding mortality; with a correction.
Berthelsen and Cronqvist recently published an article in Acta Anaesthesiologica Scandinavica including aspects which could lead on to further discussion about the Danish 1952-53 poliomyelitis epidemic. This paper considers how Bjørn Ibsen's initial approach to treatment during the epidemic was successful, as well as how it could have failed; the roles played by ventilatory failure vs. gross neurologic destruction in causing deaths; and compilations from publications of statistics concerning mortality of the epidemic. The Blegdam Hospital concept of 'life-threatening poliomyelitis' is revisited, along with its division into six anatomico-clinical categories for the 345 patients so classified. ⋯ Lassen, has been freely used. Some folklore about aspects of management is mentioned. In the light of other recent research by Dr Berthelsen an essential correction is needed in dating 'Bjørn Ibsen's Day', amending 26 August 1952 to the 27th.
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Acta Anaesthesiol Scand · Nov 2004
Randomized Controlled Trial Comparative Study Clinical TrialComparison of the analgesic efficacy of ketobemidone and morphine for management of postoperative pain in children: a randomized, controlled study.
Ketobemidone has been used as an analgesic for postoperative pain in children, but to our knowledge the effect and occurrence of adverse effects of ketobemidone compared to morphine is not known. The aim was to determine if the analgesic potency and the occurrence of adverse effects of ketobemidone differ from morphine when administered to children, as measured by patient-controlled analgesia consumption (PCA) for postoperative pain. ⋯ The analgesic potency and adverse effects of ketobemidone are similar to morphine when used for postoperative pain management in children.
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Acta Anaesthesiol Scand · Nov 2004
Randomized Controlled Trial Clinical TrialSimilar excitation after sevoflurane anaesthesia in young children given rectal morphine or midazolam as premedication.
Sevoflurane is a rapid-acting volatile anaesthetic agent frequently used in paediatric anaesthesia despite transient postoperative symptoms of cerebral excitation, particularly in preschool children. This randomised and investigator-blinded study was designed to evaluate whether premedication with an opioid might reduce non-divertible postoperative excitation more than premedication with a benzodiazepine in preschool children anaesthetized with sevoflurane. ⋯ In this study morphine for premedication in young children anaesthetized with sevoflurane was associated with similar postoperative and higher preoperative OPDS scores compared with midazolam. These findings indicate that substitution of morphine for midazolam is no useful way of reducing clinical excitation after sevoflurane anaesthesia.